NPIMap

Organization Active NPI

Peterson and Abe

  • Periodontics
  • San Diego, CA
National Provider Identifier
1942604277
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
PETERSON AND ABE
Practice address
4076 3Rd Ave
Suite 201
San Diego, CA 92103-2129
Phone
(619) 292-2322
Fax
(619) 298-0679
NPI assigned
Oct 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2014

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

Authorized official

Name
Dr. Jon Peterson, D.D.S.NPI 1285726380
Title
Periodontist
Phone
(619) 298-2322

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

4076 3Rd Ave
Suite 201
San Diego, CA 92103-2129

Mailing address

4076 3Rd Ave
Suite 201
San Diego, CA 92103-2129
Phone (619) 292-2322

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413331200000",
    "number": "1942604277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4076 3RD AVE",
            "address_2": "SUITE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032129",
            "telephone_number": "619-292-2322",
            "fax_number": "619-298-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 3RD AVE",
            "address_2": "SUITE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032129",
            "telephone_number": "619-292-2322",
            "fax_number": "619-298-0679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON AND ABE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-15",
        "last_updated": "2014-10-15",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "619-298-2322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; 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.