Andrew Petersen, D.D.S

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

7013 Issued in AZ

Practice address

7400 S Power Rd Ste 136
Gilbert, AZ 85297-9284

Phone

(480) 279-3113

Fax

(480) 279-2741

NPI assigned

Feb 1, 2007

Last updated

Dec 21, 2017By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gilbert Sonoma Oral Surgery, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Gilbert, AZ
  • NPI 1083369334
  NPD (past)
• Sonoma Oral & Facial Surgery, PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Gilbert, AZ
  • NPI 1477063881
  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1396883765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4464 S COBBLESTONE ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852974588",
            "telephone_number": "480-751-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 S POWER RD STE 136",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852979284",
            "telephone_number": "480-279-3113",
            "fax_number": "480-279-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "7013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perspective Health, LLC
• Roselyn Jessica Peter, SLPA
• Danae Peters, RBT
• Daniel Peters, PA-C
• Lindsay Peters, TATTOO ARTIST
• Elena J. Petersen, PT, DPT
• Sarah Amy Petersen, LM
• Brad Michael Peterson, CRNA
• Donna Lee Peterson, M.SC. SLP
• Jonathan J Peterson, DC

• Oral and Maxillofacial Surgery (Dentist) in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; 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.