DR. ANDREW GREGORY PETERSON (NPI# 1619318755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619318755 |
| Entity Type | Individual |
| Full Name | DR. ANDREW GREGORY PETERSON |
| Credential | DMD, MS |
| Practice Address |
15962 Boones Ferry Rd Ste 108 Lake Oswego OR 97035-4359 |
| Practice Telephone | 5036996569 |
| Mailing Telephone | 5036996569 |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2018-09-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | DE60512224 | WA | Dental Providers |
| N | 122300000X | Dentist | D9905 | OR | Dental Providers |
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
D9905 | OR | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2245 Mission St Se, Salem, OR 973021291 | 5038871844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447723044 | Andrew J Peterson | Podiatrist | 1609 Quail Dr, Sarasota, FL 34231-3538 | 2019-01-07 |
| 1720559016 | Andrew Frederick Peterson | Dentist | 1670 Beam Ave Ste 202, Maplewood, MN 55109-1225 | 2018-12-11 |
| 1326184953 | Andrew A Peterson | Dentist | 215 Justice St, Fremont, OH 43420-2420 | 2007-01-30 |
| 1477601698 | Andrew M Peterson | Pharmacist | 508 Garwood Dr, Cherry Hill, NJ 08003-3406 | 2007-01-05 |
| 1144337338 | Andrew Eric Peterson | Chiropractor | 1251 Shell Beach Rd, Pismo Beach, CA 93449 | 2006-08-24 |
| 1306826854 | Andrew J. Peterson | Internal Medicine | 147 Reynoir Street, Suite 101, Biloxi, MS 39530 | 2006-01-20 |
| 1649877069 | Andrew Peterson | Massage Therapist | 2902 164th St Sw Ste D1, Lynnwood, WA 98087-3201 | 2020-10-08 |
| 1255995536 | Andrew Curtis Peterson | Student in an Organized Health Care Education/Training Program | 701 Park Ave, Minneapolis, MN 55415-1623 | 2019-04-23 |
| 1679028534 | Andrew Peterson | Physical Therapist | 360 Dardanelli Ln, Suite 1f, Los Gatos, CA 95032-1421 | 2016-08-22 |
| 1952783698 | Andrew Joseph Peterson | Family Medicine | 110 N Hospital Dr, Fulton, MO 65251-2511 | 2015-06-18 |
| Street Address |
15962 BOONES FERRY RD STE 108 |
| City | LAKE OSWEGO |
| State | OR |
| Zip Code | 97035-4359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457875700 | Peterson Orthodontics & Periodontics, LLC | Dentist | 15962 Boones Ferry Rd Ste 108, Lake Oswego, OR 97035-4359 | 2017-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700127 | Teresa Siebenaler Scott | Social Worker | 3990 Sw Collins Way, Suite 202, Lake Owsego, OR 97035 | 2020-11-04 |
| 1528671567 | Martin Henry Lees | Internal Medicine | 14 Morningview Lane, Lake Oswego, OR 97035 | 2020-08-28 |
| 1356976187 | Premere Rehab LLC | Occupational Therapist | Infinity Rehab - The Springs At Lake Oswego, 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2020-03-12 |
| 1689212193 | Jennifer Chauvin | Nurse Practitioner | 20 Juarez Street, Lake Oswego, OR 97035 | 2019-12-16 |
| 1003396888 | Sarah Guenzburger | Physical Therapist | 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2018-08-21 |
| 1568964252 | Brett Johnson | Marriage & Family Therapist | 5655 Southwood Dr, Lake Oswego, OR 97035 | 2018-03-08 |
| 1912416561 | Michael Paul Long | Social Worker | 14523 Westlake Drive, Lake Oswego, Or 97035, Lake Oswego, OR 97035 | 2017-09-27 |
| 1467807859 | Misty Lohn | Nurse Practitioner | 5 Centerpointe Dr., Ste 600, Lake Oswego, OR 97035 | 2016-05-04 |
| 1326405473 | Kelsey Prince | Behavioral Analyst | 6400 Sw Rosewood St., Portland (lake Oswego), OR 97035 | 2016-01-20 |
| 1942683388 | Elizabeth Risberg Harrison | Massage Therapist | 190 Oswego Summit, Lake Oswego, OR 97035 | 2015-07-02 |
| Find all providers in zip 97035 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164605259 | Matt James Hoidal | Dentist | 300 Oswego Pointe Dr, Ste 106, Lake Oswego, OR 97034-3254 | 2007-12-11 |
| 1457875700 | Peterson Orthodontics & Periodontics, LLC | Dentist | 15962 Boones Ferry Rd Ste 108, Lake Oswego, OR 97035-4359 | 2017-07-28 |
| 1629095526 | Robert H. Woolf, Dds, PC | Dentist | 320 A Ave, Lake Oswego, OR 97034-3056 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871026062 | Leila Soltani | Dentist | 430 Sw 13th Ave Apt 2010, Portland, OR 97205 | 2017-04-05 |
| 1427504828 | Shashank Joshi | Dentist | 1739 W Harvard Ave, Roseburg, OR 97471-2716 | 2016-08-26 |
| 1982056479 | Mari Heslinga | Dentist | 21332 Sw Langer Farms Pkwy Ste 126, Sherwood, OR 97140 | 2016-07-07 |
| 1376944314 | Mikhail Garibov | Dentist | 17895 Nw Evergreen Pkwy Ste 130, Beaverton, OR 97006-7402 | 2014-09-09 |
| 1548671340 | Polaris Dental Specialists | Dentist | 620 12th Street Se, Salem, OR 97301 | 2014-05-14 |
| 1295159986 | Andrew N Dow Dmd PC | Dentist | 4750 Village Plaza Loop Ste 102, Eugene, OR 97401-6601 | 2014-02-14 |
| 1043581465 | Riverplace Periodontics PC | Dentist | 2636 Se Harrison Street, Suite A, Milwaukie, OR 97222 | 2012-01-17 |
| 1730472986 | Wilson D Lee | Dentist | 315 Nw Lost Springs Ter, #401, Portland, OR 97229-6444 | 2011-05-20 |
| 1184954422 | Kamran Haghighat Bds Ms PC | Dentist | 833 Sw 11th Ave Ste 1020, Portland, OR 97205-2124 | 2010-01-08 |
| 1467683276 | Sunny L Drake | Dentist | 2235 Mission St Se Ste 250, Salem, OR 97302-1294 | 2009-07-29 |
| Find all providers with the same taxonomy | ||||
| City | LAKE OSWEGO |
| Zip Code | 97035 |
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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.