Christopher Lawrence Petterson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN7570 Issued in FL

Practice address

10157 S Federal Hwy
Port St Lucie, FL 34952-5609

Phone

(772) 337-1127

Fax

(772) 337-1121

NPI assigned

Oct 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1932397536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BEACH SUMMIT CT",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334779629",
            "telephone_number": "561-743-5230",
            "fax_number": "561-743-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10157 S FEDERAL HWY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525609",
            "telephone_number": "772-337-1127",
            "fax_number": "772-337-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTERSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN7570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Winston Leonard Peterson III, D.C.
• Rosemita Petion
• Julienne Petit Frere
• Dawn M Petrie, BCABA
• Matthew W Petrovic, D.C.
• Shalita Pettway
• Lisa Karen Pezzullo, CRTT
• Elisabeth E. Pfirrmann, MSW
• Bettina Phagan, M.A.
• Sarah Anabelle Phajou Louis

• General Practice Dentistry in Port St Lucie, FL
• Providers in Port St Lucie, 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 Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.