Provider Type Icon

DENNIS G PETTIT DDS INC NPI 1356667323


NPI Information

NPI: 1356667323
Provider Name: DENNIS G PETTIT DDS INC
Classification: Clinic/Center - 261QS0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
1762 COMMERCE CENTER BLVD
FAIRBORN, OH
ZIP 45324
Phone: (937) 878-8694
Get Directions

DENNIS G PETTIT DDS INC is an oral and maxillofacial surgery clinic center in Fairborn, OH. The provider is an oral and maxillofacial surgery clinic or center specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DENNIS G PETTIT DDS INC NPI is 1356667323. The provider is registered as an organization entity type.

The provider's business location address is:

1762 COMMERCE CENTER BLVD
FAIRBORN, OH
ZIP 45324-358
Phone: (937) 878-8694

The provider's authorized official is Dennis G. Pettit .
The authorized official title is Owner/provider and has the following contact phone number (937) 878-8694.

The enumeration date for this NPI number is 4/15/2010 and was last updated on 4/23/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QS0112XClinic/CenterOral and Maxillofacial Surgery30-01-8161OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1U17952MEDICARE UPINOHIO
20695609MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.