Peter V. Vanstrom, DDS, PC

Primary specialty

DentistTaxonomy code 122300000X

License

10656 Issued in GA

Legal business name

PETER V. VANSTROM, DDS, PC

Practice address

2296 Henderson Mill Rd NE Ste 108
Atlanta, GA 30345-2739

Phone

(404) 325-2905

Fax

(678) 735-3148

NPI assigned

Jul 21, 2014

Last updated

Jul 21, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Peter V. Vanstrom, D.D.S.NPI 1831289677

Title

Ceo

Phone

(404) 325-2905

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter Victor Vanstrom, DDS

  • General Practice Dentistry
  • Tucker, GA
  • NPI 1831289677
  NPD (past) Authorized official

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1184031239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2296 HENDERSON MILL RD NE STE 108",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452739",
            "telephone_number": "404-325-2905",
            "fax_number": "678-735-3148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2296 HENDERSON MILL RD NE STE 108",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452739",
            "telephone_number": "404-325-2905",
            "fax_number": "678-735-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER V. VANSTROM, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "VANSTROM",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-325-2905",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "10656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Lynn Petcka, MD
• Karen Pete, RN
• Peter a Pate, DDS, LLC (Dentistry in Buckhead)
• Peter Marie House
• Peter R Cranton, P.C.
• Allison Peterka
• Kewashah N Peterkin
• Sophia Brothers Peterman, M.D.
• Allyssa Peters, RBT
• Catherine Bost Peters, M.D.

• Dentist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.