John C. Peterson D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

28789 Issued in CA

Legal business name

JOHN C. PETERSON D.D.S.

Practice address

8729 La Tijera Blvd
Los Angeles, CA 90045-3906

Phone

(310) 670-2646

Fax

(310) 670-1618

NPI assigned

May 2, 2016

Organization subpart

Yes

Parent organization

CRAIG B. PURSUIT D.D.S. INC.As reported in NPPES

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

Authorized official

Name

Dr. Craig B. Pursuit, D.D.S.NPI 1073521928

Title

Dentist

Phone

(310) 670-2646

Specialties & licenses 1

Addresses

Other names 1

• Craig B. Pursuit D.D.S. Inc. 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.

• Craig B Pursuit, DDS

  • Dentist
  • La, CA
  • NPI 1073521928
  NPD (past) Authorized official

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462147200000",
    "number": "1871948448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8729 LA TIJERA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453906",
            "telephone_number": "310-670-2646",
            "fax_number": "310-670-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8729 LA TIJERA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453906",
            "telephone_number": "310-670-2646",
            "fax_number": "310-670-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C. PETERSON D.D.S.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRAIG B. PURSUIT D.D.S. INC.",
        "enumeration_date": "2016-05-02",
        "last_updated": "2016-05-02",
        "status": "A",
        "authorized_official_last_name": "PURSUIT",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "310-670-2646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "28789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Craig B. Pursuit D.D.S. Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.