NPI Code Detail JSON Logo

1942090907 NPI number — ALLISON JEAN PETRARCA DMD

NPI Number: 1942090907
Health Care Provider/Practitioner: ALLISON JEAN PETRARCA DMD

Information about “1942090907” NPI (ALLISON JEAN PETRARCA DMD) exists in 1942090907 in HTML format HTML  |  1942090907 in plain Text format TXT  |  1942090907 in PDF (Portable Document Format) PDF  |  1942090907 in an XML format XML  formats.

NPI Number : 1942090907 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1942090907",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PETRARCA",
    "FirstName": "ALLISON",
    "MiddleName": "JEAN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DMD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PAVLAN",
    "OtherFirstName": "ALLISON",
    "OtherMiddleName": "JEAN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "DMD",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "5797 MADISON AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EXPORT",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "15632-1318",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "412-607-8105",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1789 S BRADDOCK AVE STE 410",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PITTSBURGH",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "15218-1881",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "412-247-2310",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/12/2025",
    "LastUpdateDate": "06/24/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223G0001X",
        "TaxonomyName": "General Practice Dentistry",
        "LicenseNumber": "DS045128",
        "LicenseNumberStateCode": "PA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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