Theodore Alan Peterson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21281 Issued in CA

Practice address

826 Altos Oaks Dr
Suite 1
Los Altos, CA 94024-5403

Phone

(650) 941-6557

Fax

(650) 941-6559

NPI assigned

May 22, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Saumya Ram DDS, Inc

  • General Practice Dentistry
  • Los Altos, CA
  • NPI 1659143592
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972712123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 ALTOS OAKS DR",
            "address_2": "SUITE 1",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940245403",
            "telephone_number": "650-941-6557",
            "fax_number": "650-941-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 ALTOS OAKS DR",
            "address_2": "SUITE 1",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940245403",
            "telephone_number": "650-941-6557",
            "fax_number": "650-941-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "THEODORE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "21281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy Nightingale Person, MFT
• Lucas Kekoa Persyn
• Peter T. Hong, D.M.D. a Professional Dental Corporation
• Nancy Lynn Petersilge, M.D.
• Kristina Peterson, MFT
• Yasmin Philipos, LMFT
• Alexandra Alden Phillippe, MFT
• Anh Quynh Phung, PA-C
• Physical Therapy for Health, Inc
• Physiofit Physical Therapy & Wellness, P.C.

• General Practice Dentistry in Los Altos, CA
• Providers in Los Altos, CA by specialty
• General Practice Dentistry in California

• 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.

Verify at the official NPI Registry.