DR. BRIAN GARRY PETRAS (NPI# 1316084916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316084916 |
| Entity Type | Individual |
| Full Name | DR. BRIAN GARRY PETRAS |
| Credential | DMD |
| Practice Address |
2121 Shelly Dr Indiana PA 15701-2395 |
| Practice Telephone | 7244638050 |
| Practice Fax Number | 7244633544 |
| Mailing Telephone | 7244638050 |
| Mailing Fax Number | 7244633544 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DS029982L | PA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164792180 | Brian Petras | Pharmacist | 148 Eastern Blvd #400, Glastonbury, CT 06033 | 2012-01-06 |
| Street Address |
2121 SHELLY DR |
| City | INDIANA |
| State | PA |
| Zip Code | 15701-2395 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922089101 | Todd Michael Keppich | Optometrist | 2121 Shelly Dr, Indiana, PA 15701-2395 | 2005-11-07 |
| 1639470008 | Jamil Ahmed Md PC | Legal Medicine | 2121 Shelly Dr, Indiana, PA 15701-2395 | 2010-11-16 |
| 1437319944 | Ryan W Cowburn Od | Optometrist | 2121 Shelly Dr, Indiana, PA 15701-2395 | 2008-06-10 |
| 1972722056 | Michael Petras | Dentist | 2121 Shelly Dr, Indiana, PA 15701-2395 | 2007-04-25 |
| 1669487252 | Ryan William Cowburn | Optometrist | 2121 Shelly Dr, Indiana, PA 15701-2395 | 2006-07-30 |
| 1871512376 | Jamil Ahmed | Legal Medicine | 2121 Shelly Dr, Indiana, PA 15701-2395 | 2006-07-18 |
| 1407875909 | Durre Ahmed | Legal Medicine | 2121 Shelly Dr, Indiana, PA 15701-2395 | 2006-07-18 |
| 1609839570 | Samuel Ralph Lanzino | Dentist | 2121 Shelly Dr, Indiana, PA 15701-2395 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518508811 | Paula A. Smulik | Pharmacist | 280 Indian Springs Rd Ste 125, Indiana, PA 15701 | 2019-10-08 |
| 1588143713 | William Aden Bendgen IIi | Counselor | 470 N 4th Street, Indiana, PA 15701 | 2018-08-08 |
| 1699266452 | Shiela Ikasilon Otwane | Nurse Practitioner | 1 Regency Square, 1524 Oakland Avenue, Indiana, PA 15701 | 2018-05-28 |
| 1881184745 | Samantha Nichcol Bennett | Social Worker | 793 Old Rte 119 Hwy U, Indiana, PA 15701 | 2018-05-16 |
| 1780193896 | Abbey Mae Hill | Counselor | 793 Old Rotue 119 Hwy N, Indiana, PA 15701 | 2017-09-21 |
| 1568819456 | Karissa Wess Angleson | Physician Assistant | Indiana Regional Medical Center Emergency Department, 835 Hospital Rd, Indiana, PA 15701 | 2016-05-20 |
| 1588020721 | Forefront Dermatology, S.c. | Dermatology | 120 I.r.m.c. Drive, Suite 130, Indiana, PA 15701 | 2016-01-04 |
| 1881069201 | Amanda J Orvosh | Counselor | 1163 Water St, Indiana, PA 15701 | 2015-12-10 |
| 1245602887 | Susan Marie Marchezak | Nurse Practitioner | 2128 Oakland Avenue, Indiana, PA 15701 | 2015-10-22 |
| 1538546353 | Hillary Beth Stitt | Counselor | 793 Old Rt 119 Hwy N, Community Guidance Center, Indiana, PA 15701 | 2015-04-30 |
| Find all providers in zip 15701 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053929034 | East Market Family Dental, Pllc | Dentist | 1177 S 6th St Ste E, Indiana, PA 15701-3759 | 2020-07-16 |
| 1215197934 | James Anthony Connelly | Dentist | 2277 Warren Rd, Indiana, PA 15701 | 2008-06-16 |
| 1780802496 | David Leo Crawford | Dentist | 1265 Wayne Ave Ste 108, Indiana, PA 15701-3501 | 2007-04-20 |
| 1497874085 | Scott F. Dills | Dentist | 880 Church St, Indiana, PA 15701-2743 | 2007-03-28 |
| 1326106741 | Chestnut Hills Dental | Dentist | 655 Church Street, Suite #300 West, Indiana, PA 15701 | 2006-12-05 |
| 1982788675 | Robert Edward Vernocy | Dentist | 911 Chestnut St, Indiana, PA 15701-1731 | 2006-10-25 |
| 1528159399 | Joseph E Marko Jr. | Dentist | 450 N 9th St, Indiana, PA 15701-1273 | 2006-09-27 |
| 1558468652 | Gaylan Keith Ross | Dentist | 1290 Mansfield Ave, Indiana, PA 15701-2340 | 2006-09-20 |
| 1396753638 | Ralph G Gilliland, Jr | Dentist | 425 Philadelphia St, Indiana, PA 15701-3909 | 2006-08-03 |
| 1679597603 | Deborah Louise Edwards | Dentist | 27 S 9th St, Indiana, PA 15701-2602 | 2006-07-26 |
| Find all providers in INDIANA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.