Michelle Lynn Petersen, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5735 Issued in KS

Practice address

8010 State Line Rd
Suite 210
Prairie Village, KS 66208-3710

Phone

(913) 341-2200

Fax

(913) 648-7605

NPI assigned

Feb 28, 2006

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

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063488047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 STATE LINE RD",
            "address_2": "SUITE 210",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662083710",
            "telephone_number": "913-341-2200",
            "fax_number": "913-648-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8010 STATE LINE RD",
            "address_2": "SUITE 210",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662083710",
            "telephone_number": "913-341-2200",
            "fax_number": "913-648-7605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "5735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne-Marie Peiker, COTA/L
• Lydia Pemberton, DPT
• Galilea Perez, RBT
• Periodontal Care, P.a.
• Kylie Peters, RBT
• Conner Peterson
• Lyn Brooks Petro
• Kelly Nicole Pettit
• Phoenix Rising Telepsych
• Physicians Reference Laboratory LLC

• General Practice Dentistry in Prairie Village, KS
• Providers in Prairie Village, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.