Active NPI
Mathilde C Peters, DMD, PHD
- Dentist
- Ann Arbor, MI
National Provider Identifier
1750577383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901017122
- Practice address
- 1011 N University Ave
Ann Arbor, MI 48109-1078 - Phone
- (734) 763-3366
- Fax
- (734) 936-1597
- NPI assigned
- Sep 18, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2901017122 | MI | Primary |
Addresses
Primary practice location
1011 N University Ave
Ann Arbor, MI 48109-1078
Mailing address
1011 N University Ave
Ann Arbor, MI 48109-1078
Phone (734) 763-3366
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901017122 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190073600000",
"number": "1750577383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 N UNIVERSITY AVE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481091078",
"telephone_number": "734-763-3366",
"fax_number": "734-936-1597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 N UNIVERSITY AVE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481091078",
"telephone_number": "734-763-3366",
"fax_number": "734-936-1597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "MATHILDE",
"middle_name": "C",
"credential": "DMD, PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-18",
"last_updated": "2007-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901017122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.