Daniel Allen Petersen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00006331 Issued in WA

Practice address

7223 W Clearwater Ave
Kennewick, WA 99336

Phone

(509) 783-8822

Fax

(509) 783-1983

NPI assigned

Mar 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• James P. Chapados, DDS, P.S.

  • General Practice Dentistry
  • Kennewick, WA
  • NPI 1851476055
  NPD (past)
• Lance W. Gledhill, DDS, PLLC

  • General Practice Dentistry
  • Kennewick, WA
  • NPI 1235481052
  NPD (past)

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1083673271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7223 W CLEARWATER AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "99336",
            "telephone_number": "509-783-8822",
            "fax_number": "509-783-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7223 W CLEARWATER AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "99336",
            "telephone_number": "509-783-8822",
            "fax_number": "509-783-1983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "DANIEL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "5871PE",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "685412",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WDS DELTA",
            "identifier": "75693",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5012711",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Perry, D.D.S.
• Amy Darhui Person, M.D.
• Pattrisha Pesina, CDP
• Peter Donald Maher IV, M.D., PLLC
• Amanda D Petersen, PA-C
• Jared M. Petersen, DO
• Peterson Medical LLC
• Kathleen Peterson, PHARMD
• Kathleen M Peterson, MED
• Rebecca Marie Peterson, RN

• General Practice Dentistry in Kennewick, WA
• Providers in Kennewick, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; 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.