DR. JOHN ROBERT PETERSEN (NPI# 1508422411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508422411 |
| Entity Type | Individual |
| Full Name | DR. JOHN ROBERT PETERSEN |
| Credential | DDS |
| Practice Address |
4555 Erin Dr Eagan MN 55122-3398 |
| Mailing Address |
3200 Hilldale Ave Ne St Anthony MN 55418-2502 |
| Practice Telephone | 6516819044 |
| Practice Fax Number | 6516810599 |
| Mailing Telephone | 6127903615 |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2019-05-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D13993 | MN | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962646224 | John Thomas Petersen | Registered Nurse | 1901 Medi Park Dr Ste 2051, Amarillo, TX 79106-2169 | 2009-04-29 |
| 1497973630 | John Robert Petersen | Chiropractor | 2216 County Road D W, Saint Paul, MN 55112-7500 | 2007-04-23 |
| 1720110737 | John William Petersen | Chiropractor | 12000 Elm Creek Blvd N Ste L70, Maple Grove, MN 55369-7167 | 2007-03-12 |
| 1851491526 | John Anthony Petersen | Psychologist | 922 E Wayne St # 205, South Bend, IN 46617-3024 | 2006-09-23 |
| 1790786895 | John Peter Petersen | Radiology | 3555 10th Court, Indian River Regional Cancer Center, Irmc, Vero Beach, FL 32960-4862 | 2005-08-10 |
| 1619361805 | John Devin Petersen | Pediatrics | 757 Westwood Plz, B711 Rrumc, Los Angeles, CA 90095-7419 | 2015-03-25 |
| 1841587854 | John Roger Petersen | Pathology | 301 University Blvd, Galveston, TX 77555-0551 | 2011-06-29 |
| 1114167434 | John Seigfred Petersen | Dentist | 415 Central Ave, Whitefish, MT 59937-2770 | 2009-02-26 |
| 1588868939 | John William Petersen | Internal Medicine | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2007-06-11 |
| 1164580429 | John J Petersen | Physician Assistant | 520 Medical Center Dr, Suite 201, Medford, OR 97504-4334 | 2006-12-05 |
| Street Address |
4555 ERIN DR |
| City | EAGAN |
| State | MN |
| Zip Code | 55122-3398 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326048422 | Linda S. Raasch | Psychologist | 4555 Erin Dr, Suite 260, Eagan, MN 55122-3398 | 2005-07-29 |
| 1902146335 | Eagan Valley Dental Center P.a. | Dentist | 4555 Erin Dr, Eagan, MN 55122-3398 | 2013-02-21 |
| 1063620276 | Nancy Nutting Cohen | Marriage & Family Therapist | 4555 Erin Dr, Suite 260, Eagan, MN 55122-3398 | 2007-05-19 |
| 1629135819 | Brandon Mannie D.c. LLC | Chiropractor | 4555 Erin Dr, 210, Eagan, MN 55122-3398 | 2007-01-03 |
| 1376690529 | Aslan Institute | Psychologist | 4555 Erin Dr, Suite 260, Eagan, MN 55122-3398 | 2007-01-03 |
| 1649371063 | John David Mittelsteadt | Dentist | 4555 Erin Dr, Eagan, MN 55122-3398 | 2006-09-26 |
| 1447238381 | Colin Hollidge | Social Worker | 4555 Erin Dr, Suite 260, Eagan, MN 55122-3398 | 2005-12-31 |
| 1194707869 | Lyndall Johnson | Psychologist | 4555 Erin Dr, #260, Eagan, MN 55122-3398 | 2005-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730651753 | Alvaro Jesus Jimenez Aguilar | Registered Nurse | 1764 Silver Bell Rd, Eagan, MN 55122 | 2019-01-02 |
| 1194213280 | Amherst H. Wilder Foundation | Lodging | Lincoln Place, 1997 Gold Trail, Eagan, MN 55122 | 2018-04-25 |
| 1831541168 | Mackenzie Lea Kerber | Counselor | 3410 Federal Dr Suite 101, Eagan, MN 55122 | 2016-07-11 |
| 1285010074 | Eagan Pointe Senior Living | Assisted Living Facility | 4232 Black Hawk Road, Eagan, MN 55122 | 2015-08-04 |
| 1700268828 | Kara Beth Rose | Specialist/Technologist | 4560 Cinnamon Ridge Trail, Eagan, MN 55122 | 2015-06-25 |
| 1558740803 | Samuel Johnson | Physician Assistant | 2901 Metro Drive, Suite 527, Bloomington, MN 55122 | 2015-05-20 |
| 1528451028 | Judi Ross Holistic Therapy, LLC | Marriage & Family Therapist | 4141 Old Sibley Memorial Highway, Eagan, MN 55122 | 2015-03-09 |
| 1447649637 | Leah Ruth Streitman | Physician Assistant | 3460 Washington Dr Ste 200, Eagan, MN 55122 | 2015-01-12 |
| 1518362193 | Cedar Valley Center for Child & Family Therapy | Preferred Provider Organization | 3460 Washington Dr., Suite 110, Eagan, MN 55122 | 2014-10-25 |
| 1316351703 | Wecare Dental of Eagan P.c | Clinic/Center | 1625 Lena Court Suite 100, Eagan, MN 55122 | 2014-06-13 |
| Find all providers in zip 55122 | ||||
| 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 |
|---|---|---|---|---|
| 1205443850 | Birchwood Dental, LLC | Dentist | 3356 Sherman Crt Ste 101, Eagan, MN 55121 | 2020-09-28 |
| 1730734708 | Ideal Dental Pllc | Dentist | 2130 Cliff Rd Ste 107, Eagan, MN 55122-2486 | 2019-08-07 |
| 1760972749 | Nicholas Theodore Schulte | Dentist | 1960 Cliff Lake Rd Ste 127, Eagan, MN 55122-2439 | 2018-05-15 |
| 1710357520 | Modern Dental Professionals, Mn PC | Dentist | 1625 Lena Ct, Suite 100, Eagan, MN 55122-2959 | 2015-10-06 |
| 1184093551 | Eagan Smiles Dentistry, PC | Dentist | 3405 Promenade Ave, Suite 300, Eagan, MN 55123-4404 | 2015-09-16 |
| 1225265309 | Molly Anne Henry | Dentist | 1965 Cliff Lake Rd, Suite #102, Eagan, MN 55122-2590 | 2009-06-16 |
| 1144353780 | Eagan Family Dentistry | Dentist | 4178 Knob Dr Ste C, Eagan, MN 55122-1875 | 2007-03-13 |
| 1871632026 | Karrie Marie Glasgow | Dentist | 1260 Yankee Doodle Rd, Suite 102, Eagan, MN 55121-2201 | 2007-02-05 |
| 1528127917 | Mark Joseph Skala | Dentist | 1905 Plaza Dr, Eagan, MN 55122-2883 | 2006-12-08 |
| 1841368545 | Dr Gerald W Rauchwarter Dds LLC | Dentist | 1960 Cliff Lake Road, #127, Eagan, MN 55122 | 2006-12-01 |
| Find all providers in EAGAN | ||||
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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.