Active NPI
Christian D Petersen, DDS, MS
- General Practice Dentistry
- Fort Carson, CO
National Provider Identifier
1477006047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7312
- Practice address
- 1650 Cochrane Cir
Fort Carson, CO 80913-4613 - Phone
- (719) 526-6899
- NPI assigned
- Jul 29, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7312 | NE | Primary |
Addresses
Primary practice location
1650 Cochrane Cir
Fort Carson, CO 80913-4613
Mailing address
1650 Cochrane Cir BLDG 7500
Fort Carson, CO 80913-4613
Phone (719) 526-6899
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7312 | NE | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776729600000",
"number": "1477006047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 COCHRANE CIR BLDG 7500",
"city": "FORT CARSON",
"state": "CO",
"postal_code": "809134613",
"telephone_number": "719-526-6899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 COCHRANE CIR",
"city": "FORT CARSON",
"state": "CO",
"postal_code": "809134613",
"telephone_number": "719-526-6899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "CHRISTIAN",
"middle_name": "D",
"credential": "DDS, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-29",
"last_updated": "2026-04-21",
"certification_date": "2026-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NE",
"license": "7312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Carson, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.