DR. KRISTY LYNN PETERSEN (NPI# 1407948060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407948060 |
| Entity Type | Individual |
| Full Name | DR. KRISTY LYNN PETERSEN |
| Credential | DDS |
| Practice Address |
10150 City Walk Dr Apt C Woodbury MN 55129-9270 |
| Practice Telephone | 6517145555 |
| Mailing Telephone | 6517145555 |
| Mailing Fax Number | 6517149005 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2018-01-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 5884015 | WI | Dental Providers |
| Y | 122300000X | Dentist | D12087 | MN | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003313115 | Kristy L Petersen | Nurse Practitioner | 540 The Rialto, Venice, FL 34285-2900 | 2018-04-06 |
| 1225127798 | Kristy Petersen | Family Medicine | 3517 W Owen K Garriott Rd, Suite Four, Enid, OK 73703-4952 | 2006-10-12 |
| Street Address |
10150 CITY WALK DR APT C |
| City | WOODBURY |
| State | MN |
| Zip Code | 55129-9270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517093 | Orthodontic Specialists of Minnesota, Pllc | Dentist | 10150 City Walk Dr Apt C, Woodbury, MN 55129-9270 | 2020-10-28 |
| 1902235245 | Dental Specialists of Minnesota, Pllc | Dentist | 10150 City Walk Dr Apt C, Woodbury, MN 55129-9270 | 2013-11-07 |
| 1184716755 | Lori Marie Gmeinder | Dentist | 10150 City Walk Dr Apt C, Woodbury, MN 55129-9270 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770006983 | Logan Thompson | Chiropractor | 10631 Pond Curve, Woodbury, MN 55129 | 2017-07-19 |
| 1942650619 | The Hendricks Group Inc. | Assisted Living Facility | 10025 Antrim Court, Woodbury, MN 55129 | 2016-06-14 |
| 1235588468 | Nathan Robert Mayernik | Physical Therapist | 4123 Radio Dr, Suite 100, Woodbury, MN 55129 | 2016-06-08 |
| 1699146035 | St. Therese of Woodbury, LLC | Skilled Nursing Facility | 7555 Bailey Road, Woodbury, MN 55129 | 2015-10-12 |
| 1548602865 | Monica Bajracharya | Internal Medicine | 9373 Compass Pointe Rd, Woodbury, MN 55129 | 2013-07-28 |
| 1730454752 | Amanda E Feeney | Physical Therapist | 4123 Radio Drive, Ste 100, Woodbury, MN 55129 | 2012-03-09 |
| 1104193762 | Minneapolis-st.paul Endodontics | Dentist | 10150 City Walk Dr Ste C, Woodbury, MN 55129 | 2011-11-28 |
| 1659502417 | Charles Goff Jr. | Marriage & Family Therapist | 1919 University Ave W Suite 200, St. Paul, MN 55129 | 2009-07-28 |
| 1497821391 | Kyle Riley Edlund | Dentist | 3060 Woodbury Drive, #b, Woodbury, MN 55129 | 2006-11-24 |
| 1902979206 | Robert Edgar Eng | Dentist | 3100 Woodbury Drive, Woodbury, MN 55129 | 2006-11-16 |
| Find all providers in zip 55129 | ||||
| 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 |
|---|---|---|---|---|
| 1699393942 | Danika Elizabeth Jackson | Dentist | 237 Radio Dr Ste 110, Woodbury, MN 55125-4478 | 2020-07-13 |
| 1972165678 | Dentists of Woodbury, PC | Dentist | 7150 Valley Creek Plz Ste 230, Woodbury, MN 55125-2271 | 2019-07-02 |
| 1174095319 | Asnis Dental, Pllc | Dentist | 800 Woodbury Rd Ste E, Woodbury, NY 11797-2503 | 2018-12-28 |
| 1912498148 | Woodbury Sleep Solutions Pa | Dentist | 2070 Eagle Creek Ln Ste 300, Woodbury, MN 55129-3218 | 2018-05-23 |
| 1134619117 | Christopher Schweiger | Dentist | 580 Woodbury Dr Ste 300, Woodbury, MN 55125-4949 | 2018-05-15 |
| 1083090641 | Daniela Haase | Dentist | 429 Commerce Dr, #400, Woodbury, MN 55125-6600 | 2015-08-06 |
| 1669864211 | Tamer Barsom | Dentist | 360 Fairhaven Blvd, Woodbury, NY 11797-1628 | 2015-02-19 |
| 1417347006 | Daniel Kim | Dentist | 800 Woodbury Rd Ste B, Woodbury, NY 11797-2503 | 2015-02-03 |
| 1548659824 | Woodbury Smiles Dentistry, PC | Dentist | 580 Woodbury Dr, Suite 300, Woodbury, MN 55125-4948 | 2015-01-09 |
| 1740696327 | Kathryn Connell | Dentist | 8325 Seasons Pkwy Ste 103, Woodbury, MN 55125-3602 | 2014-07-03 |
| Find all providers in WOODBURY | ||||
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| 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.