Andrew John Peterson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901021570 Issued in MI

Practice address

1010 N 3Rd St
Marquette, MI 49855-3510

Phone

(906) 228-7087

NPI assigned

Jun 2, 2015

Sex

Male

Sole proprietor

Yes

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.

• Donn G. Kipka, Jr., D.D.S., P.C.

  • General Practice Dentistry
  • Marquette, MI
  • NPI 1447477666

  General Practice

  NPD (past)

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1326428640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N 3RD ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498553510",
            "telephone_number": "906-228-7087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N 3RD ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498553510",
            "telephone_number": "906-228-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901021570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Marie Perrier, PA-C
• Alexis Danielle Perttu, FNP
• David Arvo Pesola, MD
• Jessica Pesola, LMT
• Morgan Peters, PA
• Heidi Jane Peterson, RPH
• Richard A Peura, DDS
• Rachael Beth Phillips
• Natalie Pianetto, DNP, FNP-BC
• Tori Ann Pickens, RBT

• All providers in Marquette, MI
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.