Dena Petersen, M.D. P.C

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

DENA PETERSEN, M.D. P.C

Practice address

4574 N 1St Ave Ste 180
Tucson, AZ 85718-5699

Phone

(520) 293-1415

Fax

(520) 293-1434

NPI assigned

Nov 19, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Dena E Petersen, M.D.

Title

Owner

Phone

(520) 293-1415

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228176000000",
    "number": "1750536611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4574 N 1ST AVE STE 180",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857185699",
            "telephone_number": "520-293-1415",
            "fax_number": "520-293-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4574 N 1ST AVE STE 180",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857185699",
            "telephone_number": "520-293-1415",
            "fax_number": "520-293-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENA PETERSEN, M.D. P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-19",
        "last_updated": "2008-12-02",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "DENA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-293-1415",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREPCARE",
            "identifier": "10296",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "AZ0817530",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "Z20625",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "0100823",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9778467",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey A Demoss, DO
• Lynnette Eileen Demosthenes, FAMILY MEDICINENP-BC
• Melinda Maria Dempsey
• John Dempster Jr., M.D.
• Shale Lynn Demuth, OD
• Antony Denard Jr., M.D.
• Stephen Allen Denbrock, DDS
• Gisele Denepitiya, MD
• Cathy Wu Deng
• Joanna S Deng, PHARMD

• Exclusive Provider Organization in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Exclusive Provider Organization in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; 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.