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NPI Code Detail

MEDICARE: DR. SIMON GERARD PETRIZZI DDS

MEDICARE:  DR. SIMON GERARD PETRIZZI  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry0401420022VA

General Provider Information

NPI Number : 1134057144
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SIMON GERARD PETRIZZI DDS
Provider Business Mailing Address
First Line : 3250 ANDERSON HWY
Second Line :
City : POWHATAN
State : VA
Zip : 23139-7307
Country : US
Telephone Number : 804-803-1883
Fax Number :
Provider Business Practice Location Address
First Line : 3250 ANDERSON HWY
Second Line :
City : POWHATAN
State : VA
Zip : 23139-7307
Country : US
Telephone Number : 804-531-3550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2026
Last Update Date : 05/26/2026

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Directions to “ DR. SIMON GERARD PETRIZZI DDS” Practice Location

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