DR. MICHELLE LYNN PETERSEN (NPI# 1063488047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063488047 |
| Entity Type | Individual |
| Full Name | DR. MICHELLE LYNN PETERSEN |
| Credential | D.D.S. |
| Practice Address |
8010 State Line Rd Suite 210 Prairie Village KS 66208-3710 |
| Practice Telephone | 9133412200 |
| Practice Fax Number | 9136487605 |
| Mailing Telephone | 9133412200 |
| Mailing Fax Number | 9136487605 |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
5735 | KS | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568710671 | Michelle E Petersen | Physical Therapist | 3875 Wedgewood Ln, The Villages, FL 32162-9301 | 2012-08-21 |
| 1538203476 | Michelle A Petersen | Physician Assistant | 2221 S 17th St Ste 202, Lincoln, NE 68502 | 2007-02-16 |
| 1063644953 | Michelle L Petersen | Pharmacist | 735 Spruce St, Myrtle Point, OR 97458-1154 | 2009-08-11 |
| 1700041472 | Michelle K Petersen | Nurse Practitioner | 5300 Memorial Dr, Two Rivers, WI 54241 | 2008-07-22 |
| 1588778740 | Michelle Petersen | Kinesiotherapist | 1901 S 1st St, Temple, TX 76504-7451 | 2006-08-17 |
| 1811972458 | Michelle E Petersen | Nurse Practitioner | 1608 E Evergreen St, Suite A, Cameron, MO 64429-2400 | 2005-12-07 |
| 1447247838 | Michelle B Petersen | Pediatrics | 7441 O St, Suite 303, Lincoln, NE 68510-2468 | 2005-09-30 |
| Street Address |
8010 STATE LINE RD SUITE 210 |
| City | PRAIRIE VILLAGE |
| State | KS |
| Zip Code | 66208-3710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568630226 | Claire L Barron Phd. Inc. | Psychologist | 8010 State Line Rd, Suite 230, Prairie Village, KS 66208-3710 | 2008-02-15 |
| 1861517328 | Claire L Barron | Psychologist | 8010 State Line Rd, Ste 230, Prairie Village, KS 66208-3710 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023627940 | Arena Health LLC | Clinic/Center | 8010 Stateline Road, Suite 100, Prairie Village, KS 66208 | 2020-07-27 |
| 1780222414 | Tracy Licausi | Counselor | 4907 W 69th Ter, Prairie Village, KS 66208 | 2019-12-12 |
| 1699294959 | Meredith Arends | Physician Assistant | 2904 W 73rd Street, Prairie Village, KS 66208 | 2017-09-18 |
| 1861914616 | Pardeep Kaur Gill | Dentist | 7501 Mission Rd Ste 102, Prairie Village, KS 66208 | 2017-07-13 |
| 1366821977 | Wineteer, Inc. | Durable Medical Equipment & Medical Supplies | 3500 W 75th St, Suite 100, Prairie Village, KS 66208 | 2015-05-28 |
| 1972913374 | Julia Nguyen | Dentist | 7301 Mission Rd Ste 317, Prairie Village, KS 66208 | 2014-05-07 |
| 1063859650 | Joseph Charles Glenn | Chiropractor | 8016 State Line Rd, Suite 100, Leawood, KS 66208 | 2013-05-23 |
| 1104172337 | Julie Anne Budke | Psychologist | 3965 W 83rd Street Suite 233, Prairie Village, KS 66208 | 2012-07-25 |
| 1700149952 | Julia K Thomas | Specialist | 5111 W. 64th St, Prairie Village, KS 66208 | 2012-06-22 |
| 1255624227 | Carl S Cleveland Iv | Chiropractor | 8016 State Line Rd, Ste 100, Leawood, KS 66208 | 2011-05-24 |
| Find all providers in zip 66208 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982264586 | Austin Mitchell Stehl | Dentist | 9401 Nall Ave Ste 201, Prairie Village, KS 66207-2508 | 2019-06-17 |
| 1740793181 | Daniel Bock Dds, LLC | Dentist | 4121 W 83rd St Ste 200, Prairie Village, KS 66208-5323 | 2017-11-07 |
| 1861914616 | Pardeep Kaur Gill | Dentist | 7501 Mission Rd Ste 102, Prairie Village, KS 66208 | 2017-07-13 |
| 1417133521 | Johnson County Dental Care | Dentist | 5329 W 94th Ter, Prairie Village, KS 66207-2503 | 2008-01-18 |
| 1336270115 | Edward D. Dallam | Dentist | 5000 W 95th St Ste 300, Prairie Village, KS 66207 | 2007-03-07 |
| 1427188960 | Gary Dean Zuck | Dentist | 8132 Rosewood Dr, Prairie Village, KS 66208-5008 | 2007-03-06 |
| 1437138633 | Stephanie Michelle Warden | Dentist | 2200 West 75th Street, Suite 101, Prairie Village, KS 66208-2517 | 2006-01-16 |
| 1073591947 | Eugene Francis Mcgill | Dentist | 3700 W 83rd St, Suite 208, Prairie Village, KS 66208-5121 | 2006-01-02 |
| 1871574277 | Jennifer L Mcaroy | Dentist | 6925 Tomahawk Rd, Prairie Village, KS 66208-2618 | 2005-11-11 |
| 1740270552 | Kevin A Cattaneo | Dentist | 7301 Mission Rd, Ste. 339, Prairie Village, KS 66208-3006 | 2005-10-24 |
| Find all providers in PRAIRIE VILLAGE | ||||
| City | PRAIRIE VILLAGE |
| Zip Code | 66208 |
Please comment or provide details below to improve the information on DR. MICHELLE LYNN PETERSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.