Active NPI
Aida N. Peterson, D.D.S.,M.S.
- Endodontics
- Livonia, MI
National Provider Identifier
1922140292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 13799
- Practice address
- 16801 Newburgh Rd
Suite 105
Livonia, MI 48154-1606 - Phone
- (734) 953-6660
- Fax
- (734) 953-1093
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 13799 | MI | Primary |
Addresses
Primary practice location
16801 Newburgh Rd
Suite 105
Livonia, MI 48154-1606
Mailing address
16801 Newburgh Rd
Suite 105
Livonia, MI 48154-1606
Phone (734) 953-6660
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13799 | MI | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922140292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16801 NEWBURGH RD",
"address_2": "SUITE 105",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481541606",
"telephone_number": "734-953-6660",
"fax_number": "734-953-1093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16801 NEWBURGH RD",
"address_2": "SUITE 105",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481541606",
"telephone_number": "734-953-6660",
"fax_number": "734-953-1093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "AIDA",
"middle_name": "N.",
"name_prefix": "Dr.",
"credential": "D.D.S.,M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MI",
"license": "13799",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.