Savanna M. Peterson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 21479 Issued in FL

Practice address

1462 W Granada Blvd Ste 210
Ormond Beach, FL 32174-9167

Phone

(386) 675-1711

NPI assigned

Jul 23, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Savanna M. Kirley Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1770968422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1462 W GRANADA BLVD STE 210",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321749167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1462 W GRANADA BLVD STE 210",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321749167",
            "telephone_number": "386-675-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SAVANNA",
        "middle_name": "M.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-23",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 21479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAVANNA",
            "last_name": "KIRLEY",
            "middle_name": "M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sydney Perkins
• Gayle E Perry, CRNA
• Roderick Perry
• Tokay Perugia, LCSW
• Brian Michael Peterson, O.D.
• Marcia Kay Peterzell, APRN
• Lawrence Richard Petker, D.C.
• Vito Aniello Petrozzino, M.D.
• Tamara Fields Pettit, MS, LMFT
• Lorenzo Tien Phan, L.AC

• General Practice Dentistry in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.