DR. IAN PETERSEN (NPI# 1225569916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225569916 |
| Entity Type | Individual |
| Full Name | DR. IAN PETERSEN |
| Credential | D.M.D. |
| Practice Address |
2448 Guerneville Rd Suite 200 Santa Rosa CA 95403-4175 |
| Mailing Address |
2577 Greenvale Ln Santa Rosa CA 95401-4041 |
| Practice Telephone | 7075792808 |
| Mailing Telephone | 7074776612 |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2017-03-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 101238 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255305850 | Ian B Petersen | Specialist/Technologist | 345 Taft Road, South Holland, IL 60473 | 2006-02-13 |
| Street Address |
2448 GUERNEVILLE RD SUITE 200 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95403-4175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669454211 | Jeffrey Ian Petersen | Dentist | 2448 Guerneville Rd, Santa Rosa, CA 95403-4175 | 2005-11-18 |
| 1003153461 | Edita Vasiliauskas | Dentist | 2448 Guerneville Rd, Santa Rosa, CA 95403-4175 | 2013-01-04 |
| 1164614533 | Joshua Drew Hammer | Dentist | 2448 Guerneville Rd, Suite 700, Santa Rosa, CA 95403-4175 | 2007-08-09 |
| 1528262920 | John West Buzza | Dentist | 2448 Guerneville Rd, Suite 1200, Santa Rosa, CA 95403-4175 | 2007-06-12 |
| 1497972152 | Jan S. Rice | Acupuncturist | 2448 Guerneville Rd, Suite 1100, Santa Rosa, CA 95403-4175 | 2007-04-20 |
| 1215151675 | Jay H Callender | Acupuncturist | 2448 Guerneville Rd, Suite 400, Santa Rosa, CA 95403-4175 | 2007-04-13 |
| 1588796957 | Ron Kennedy | Internal Medicine | 2448 Guerneville Rd, Ste. 800, Santa Rosa, CA 95403-4175 | 2007-03-12 |
| 1023140977 | Michael G Carlston | Family Medicine | 2448 Guerneville Rd, Suite 900, Santa Rosa, CA 95403-7222 | 2007-03-09 |
| 1558406058 | Jay H Herdt | Acupuncturist | 2448 Guerneville Rd, 1100, Santa Rosa, CA 95403-4175 | 2007-02-21 |
| 1215086624 | Albert E Couture Jr. | Dentist | 2448 Guerneville Rd, Suite 700, Santa Rosa, CA 95403 | 2007-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912549841 | Abundance Acupuncture Healing Clinic | Acupuncturist | 3410 Mendocino Avenue, Santa Rosa, CA 95403 | 2019-10-11 |
| 1982161337 | Crystal J Ward | Registered Nurse | 2350 Mendocino Ave, Ste A4, Santa Rosa, CA 95403 | 2019-02-21 |
| 1033674379 | George Edward Griese | Respiratory Therapist, Registered | 501 Bicentennial Way, Santa Rosa, CA 95403 | 2019-01-31 |
| 1508320672 | East-west Natural Medicine Inc. | Acupuncturist | 2200 Range Ave #207, Santa Rosa, CA 95403 | 2019-01-23 |
| 1316410640 | Lionel C Cooper | Counselor | 315 Mark West Springs Road, Santa Rosa, CA 95403 | 2019-01-09 |
| 1326519182 | Jkb Solutions Inc. | In Home Supportive Care | 3554 Round Barn Boulevard, Suite 311, Santa Rosa, CA 95403 | 2018-12-05 |
| 1487121265 | Catholic Charities of The Diocese of Santa Rosa | Clinic/Center | 987 Airway Ct, Santa Rosa, CA 95403 | 2018-10-30 |
| 1447746524 | Lisa Jean Quang | Optometrist | 3925 Old Redwood, Medical Office Building 4, Suite 141, Santa Rosa, CA 95403 | 2018-07-02 |
| 1598253353 | Jennifer Renee Lummus | Community Health Worker | 3614 Condo Court, Santa Rosa, CA 95403 | 2018-04-27 |
| 1871042366 | Sadie Thuet | Marriage & Family Therapist | 3434 A Mendocino Ave, Santa Rosa, CA 95403 | 2016-09-26 |
| Find all providers in zip 95403 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487127486 | Evelyn Escobedo | Dentist | 2335 Summercreek Dr Apt 59, Santa Rosa, CA 95404-7761 | 2019-01-02 |
| 1053853242 | Stephanie Settimi Dds, Inc | Dentist | 2798 Yulupa Ave Ste 3, Santa Rosa, CA 95405-8570 | 2016-11-06 |
| 1720484835 | Sarah Gim | Dentist | 55 Mission Cir Ste 101, Santa Rosa, CA 95409-5372 | 2014-11-17 |
| 1477952182 | Stacey Diane Strong | Dentist | 95 Montgomery Address, Suite 106, Santa Rosa, CA 95404 | 2014-08-19 |
| 1225437254 | Sean Vreeburg | Dentist | 3599 Piner Rd, Santa Rosa, CA 95401-3916 | 2014-08-14 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1639510563 | Behnam Rostami | Dentist | 479 Stony Point Rd, Santa Rosa, CA 95401-5969 | 2013-07-08 |
| 1760821615 | Amanda Major | Dentist | 250 D St, Suite 200, Santa Rosa, CA 95404-4773 | 2013-06-24 |
| 1427398882 | Laura David Ellefson | Dentist | 1100 Sonoma Ave Ste A, Santa Rosa, CA 95405-8901 | 2013-02-22 |
| 1467798116 | Dental Corporation of Kelly A. Elward, Dds | Dentist | 1820 Sonoma Ave Ste 100, Santa Rosa, CA 95405-6617 | 2012-12-28 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95403 |
Please comment or provide details below to improve the information on DR. IAN 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.