Provider Demographics
NPI:1427706761
Name:HANNAPEL PELLILLO ORTHODONTICS, PLLC
Entity type:Organization
Organization Name:HANNAPEL PELLILLO ORTHODONTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SONNI
Authorized Official - Middle Name:
Authorized Official - Last Name:PELLILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:304-612-4242
Mailing Address - Street 1:6477 CHERRY MEADOW DR SE STE 2
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-7351
Mailing Address - Country:US
Mailing Address - Phone:616-891-7272
Mailing Address - Fax:
Practice Address - Street 1:6477 CHERRY MEADOW DR SE STE 2
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-7351
Practice Address - Country:US
Practice Address - Phone:616-891-7272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty