Daniel Petersen, DDS, Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

57031 Issued in CA

Legal business name

DANIEL PETERSEN, DDS, INC.

Practice address

2315 Bechelli LN
Suite a
Redding, CA 96002-0119

Phone

(530) 223-1811

Fax

(530) 223-1813

NPI assigned

Dec 17, 2008

Last updated

Dec 17, 2008By 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

Daniel Petersen, D.D.S.NPI 1497817191

Title

President

Phone

(530) 223-1811

Specialties & licenses 1

Addresses

Tax ID family

Daniel Petersen DDS Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Daniel Petersen DDS, Inc.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Redding, CA
  • NPI 1649677915
  NPD tax ID

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.

• Daniel W Petersen, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Redding, CA
  • NPI 1497817191
  Authorized official Same address or phone

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229472000000",
    "number": "1225274442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 BECHELLI LN",
            "address_2": "SUITE A",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020119",
            "telephone_number": "530-223-1811",
            "fax_number": "530-223-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 BECHELLI LN",
            "address_2": "SUITE A",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020119",
            "telephone_number": "530-223-1811",
            "fax_number": "530-223-1813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL PETERSEN, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-17",
        "last_updated": "2008-12-17",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-223-1811",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "57031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel & Max, LLC (Stanton Optical)
• Daniel B Lensink Medical Corporation (Oculofacial Plastic Surgery Center)
• Daniel B. Lensink MD Medical Corporation
• Daniel J Costigan DO Inc
• Daniel Petersen DDS, Inc.
• Jesse Daniel, BCBA
• Nicolette Danielsen, OT
• Diana M Danielson
• Danni Mason, LMFT, Psychotherapy and Training Inc (Danyela Mason, LMFT)
• Shannika Tricia Dao, D.D.S

• Oral and Maxillofacial Surgery (Dentist) in Redding, CA
• Providers in Redding, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; 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.