DR. DENNIS G PETTIT (NPI# 1356354765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1356354765 |
Entity Type | Individual |
Full Name | DR. DENNIS G PETTIT |
Credential | DDS |
Practice Address |
1762 Commerce Center Blvd Fairborn OH 45324-6358 |
Mailing Address |
1762 Commerce Center Blvd Fairborn OH 45324 |
Practice Telephone | 9378788694 |
Mailing Telephone | 9378788694 |
Mailing Fax Number | 9378781554 |
Enumeration Date | 2006-08-15 |
Last Update Date | 2008-08-12 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
30018161 | OH | Dental Providers |
N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
30-01-8161 | OH | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OH | 0695609 | 05 |
Street Address |
1762 COMMERCE CENTER BLVD |
City | FAIRBORN |
State | OH |
Zip Code | 45324-6358 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356667323 | Dennis G Pettit Dds Inc | Clinic/Center | 1762 Commerce Center Blvd, Fairborn, OH 45324-6358 | 2010-04-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023647591 | Michael Hubbell | Student in an Organized Health Care Education/Training Program | 2555 University Blvd., Fairborn, OH 45324 | 2020-04-06 |
1982243382 | Wickshire Fairborn Opco LLC | Assisted Living Facility | 2270 Park Hills Drive, Fairborn, OH 45324 | 2020-01-02 |
1104301654 | Sophia Alridge | Counselor | 594 East Dayton Yellow Springs Road, Fairborn, OH 45324 | 2018-10-01 |
1750863189 | Sydney Bowser | Behavior Technician | 1750 Commerce Center Blvd., Fairborn, OH 45324 | 2018-09-01 |
1710406798 | Chester Cashmir Torkornoo | Dentist | 3989 Colonel Glenn Hwy A, Fairborn, OH 45324 | 2017-09-11 |
1245772375 | Ranada LLC | Health Maintenance Organization | 17 Vanderbilt Drive Apt G, Fairborn, OH 45324 | 2016-11-07 |
1194277582 | Derrick Bark | Specialist/Technologist | 85 Old Yellow Springs Rd, Fairborn, OH 45324 | 2016-11-01 |
1326592635 | Sheena Elizabeth Geoghegan | Student in an Organized Health Care Education/Training Program | 725 Univerisity Blvd., Wright State Physicians, Fairborn, OH 45324 | 2016-08-04 |
1912360199 | Tarah Heath | Occupational Therapist | 2498 Dayton, Beavercreek, OH 45324 | 2016-04-04 |
1255706339 | Cierra Jackson | Counselor | 1560 Calder Ct, Fairborn, OH 45324 | 2015-12-01 |
Find all providers in zip 45324 |
Taxonomy Code | 1223P0106X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Pathology |
The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487207387 | Mehak Kaul | Dentist | 2196 Postle Hall, 305 West 12th Avenue, Columbus, OH 43210 | 2019-07-19 |
1427257401 | Kelly Lynn Podlosky | Dentist | The Ohio State University College of Dentistry, 305 W. 12th Ave., Columbus, OH 43210 | 2007-07-11 |
1861536468 | Donald L Knowles | Dentist | 1235 W Market St, Lima, OH 45805-2728 | 2007-02-16 |
1356484430 | Meredith Lee Griffith | Dentist | 1507 Lincoln Blvd, Lorain, OH 44055-3138 | 2007-02-15 |
1225177033 | Bruce Allen Fraser | Dentist | 463 Waterbury Ct, Suite A, Columbus, OH 43230 | 2007-02-06 |
1396884805 | Gregory C Michaels | Dentist | 823 N Columbus St, Lancaster, OH 43130-2549 | 2007-02-05 |
1144316126 | Faisal A Quereshy | Dentist | 3591 Reserve Commons Drive, Suite 300, Medina, OH 44256 | 2006-10-05 |
1104927524 | Ronald L Lehnowsky | Dentist | 1670 Cooper Foster Park Rd, Lorain, OH 44053-3658 | 2006-09-26 |
1649378233 | James Warren Hanna | Dentist | 1813 W Prospect Rd, Ashtabula, OH 44004-6623 | 2006-09-20 |
1386605152 | Stanley A Hirsch | Dentist | 6365 Longridge Rd, Mayfield Heights, OH 44124-4114 | 2006-03-31 |
Find all providers with the same taxonomy |
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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.