Paul a Peterson DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

52913 Issued in CA

Legal business name

PAUL A PETERSON DDS INC

Practice address

400 W Ventura Blvd #165
Camarillo, CA 93010

Phone

(805) 482-1558

Fax

(805) 484-8240

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Paul Aaron Peterson, DDS

Title

Owner/President

Phone

(805) 482-1558

Specialties & licenses 2

Addresses

Other names 1

• Peterson Center For Dentistry Doing business as

Locations

Practitioners 1

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

• Jeremy Allen Patelzick, D.D.S.

  • General Practice Dentistry
  • Camarillo, CA
  • NPI 1649462540
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1679604169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W VENTURA BLVD #165",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "93010",
            "telephone_number": "805-482-1558",
            "fax_number": "805-484-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W VENTURA BLVD #165",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "93010",
            "telephone_number": "805-482-1558",
            "fax_number": "805-484-8240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL A PETERSON DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "805-482-1558",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peterson Center For Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shana Nicole Patt
• Casey Patterson, DDS
• Erie Rose Patterson
• Erika Patterson
• Kim Cashman Patterson, MFT
• Danielle Paul, LVN
• Pdap of Ventura County, Inc.
• Pdap of Ventura County, Inc.
• Pdap of Ventura County, Inc.
• Pdap of Ventura County, Inc.

• General Practice Dentistry in Camarillo, CA
• Providers in Camarillo, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.