Ayleen R. Peterson DDS, Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

AYLEEN R. PETERSON DDS, INC.

Practice address

4221 Sunnyslope Ave
Sherman Oaks, CA 91423-3803

Phone

(310) 710-7854

NPI assigned

Dec 17, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Ayleen Peterson, DDSNPI 1801155445

Title

President

Phone

(310) 710-7854

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ayleen Rojhani Peterson, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Los Angeles, CA
  • NPI 1801155445
  NPD Authorized official

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1225509268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 SUNNYSLOPE AVE",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914233803",
            "telephone_number": "310-710-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 SUNNYSLOPE AVE",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914233803",
            "telephone_number": "310-710-7854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Lakes Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917902929",
            "country_code": "US",
            "telephone_number": "310-710-7854",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10833 Le Conte Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900953803",
            "country_code": "US",
            "telephone_number": "310-710-7854",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16661 Ventura Blvd",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "914361914",
            "country_code": "US",
            "telephone_number": "310-710-7854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AYLEEN R. PETERSON DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "AYLEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-710-7854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "4221 Sunnyslope Ave",
            "city": "Sherman Oaks",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914233803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Sherman Oaks, CA
• Providers in Sherman Oaks, 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 12, 2019; 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.