Kristina Petersen, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

H7310 Issued in OR

Practice address

13000 SW 2ND St
Beaverton, OR 97005-2615

Phone

(503) 259-5045

NPI assigned

Sep 13, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Virginia Garcia Memorial Health Center

  • Federally Qualified Health Center (FQHC)
  • Beaverton, OR
  • NPI 1588061139
  NPD (past)
• Virginia Garcia Memorial Health Center

  • Federally Qualified Health Center (FQHC)
  • Cornelius, OR
  • NPI 1679528012
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1013465566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 568",
            "city": "CORNELIUS",
            "state": "OR",
            "postal_code": "971130568",
            "telephone_number": "503-352-8657",
            "fax_number": "503-352-8658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 SW 2ND ST",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052615",
            "telephone_number": "503-259-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KRISTINA",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H7310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Perry, CSWA
• Lisa Perry
• Rebecca A Perry
• Andrew Persoon, LMT
• Jacob Duane Peters, PA-C
• Desmond Kirk Peterson, N.D.
• Glenda A Peterson, PMHN
• Jennie Michelle Peterson, PMHNP-BC
• Leslie Lucinda Peterson, RDH, OMT
• Sharon Rose Peterson, MD

• Dental Hygienist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Dental Hygienist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.