PETERSON DENTISTRY DDS INC (NPI# 1639661341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639661341 |
| Entity Type | Organization |
| Organization Name | PETERSON DENTISTRY DDS INC |
| Practice Address |
503 E Imperial Hwy Brea CA 92821-5544 |
| Practice Telephone | 7146729000 |
| Practice Fax Number | 7146729086 |
| Mailing Telephone | 7146729000 |
| Mailing Fax Number | 7146729086 |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2018-05-30 |
| Authorized Official Name | GREGORY PETERSON (OWNER) |
| Authorized Official Telephone | 7146729000 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
57102 | CA | Dental Providers |
| Street Address |
503 E IMPERIAL HWY |
| City | BREA |
| State | CA |
| Zip Code | 92821-5544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396759320 | John C Whitworth | Dentist | 503 E Imperial Hwy, Brea, CA 92821-5544 | 2006-07-27 |
| 1437311370 | Gregory Peterson | Dentist | 503 E Imperial Hwy, Brea, CA 92821 | 2008-07-01 |
| 1770591026 | Whitworth Dental Corporation | Dentist | 503 E Imperial Hwy, Brea, CA 92821 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043844921 | Christina Marie Iezza | Physical Medicine & Rehabilitation | 500 W. Central Ave, Suite B, Brea, CA 92821 | 2020-02-28 |
| 1962052068 | Joanne Chung | Behavioral Analyst | 3050 Saturn Street, #102, Brea, CA 92821 | 2019-09-19 |
| 1508336736 | Sonia Montez | Physical Therapy Assistant | Jump N Schout, 500 W Central Ave, Brea, CA 92821 | 2018-11-30 |
| 1215411921 | Eye View Optometry, Inc | Optometrist | 605 E. Imperial Hwy, Suite C, Brea, CA 92821 | 2018-09-18 |
| 1700395480 | Sheetal Patel | Registered Nurse | 955 W. Imperial Hwy., Suite 220, Brea, CA 92821 | 2017-09-25 |
| 1952827826 | Grace Cho | Occupational Therapist | 875 N Brea Blvd # 600, Brea, CA 92821 | 2017-08-22 |
| 1063959781 | Veronica Meza | Lactation Consultant, Non-RN | 551 Discovery Lane, #115, Brea, CA 92821 | 2017-01-20 |
| 1780045815 | Audrey Alva | Specialist/Technologist | 460 W. Lambert Road, Brea, CA 92821 | 2016-03-17 |
| 1558734921 | Eun Kim Chiropractic Inc | Chiropractor | 411 Atlas Street, Suite A, Brea, CA 92821 | 2015-11-07 |
| 1053784512 | Caremore Health Plan | Nurse Practitioner | 420 W. Central Avenue #a, Brea, CA 92821 | 2015-11-05 |
| Find all providers in zip 92821 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528485901 | Laura Pashkowsky | Dentist | 380 W Central Ave Ste 330, Brea, CA 92821-3066 | 2014-03-24 |
| 1982643110 | Jone Kim | Dentist | 400 W Central Ave, Suite 109, Brea, CA 92821-3013 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807979 | Ayed Hawatmeh Dds Inc | Dentist | 322 E Foothill Blvd, Pomona, CA 91767 | 2020-10-02 |
| 1114533064 | Alexander V. Antipov, D.d.s., Inc. | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678 | 2020-09-16 |
| 1609493170 | Amir Haghshenas Dds | Dentist | 3880 S Bascom Ave Ste 213, San Jose, CA 95124-2675 | 2020-07-01 |
| 1316568900 | Beech & Reid Dental Partnership | Dentist | 464 E Calaveras Blvd Ste B3, Milpitas, CA 95035-5412 | 2020-05-05 |
| 1518506773 | Francisco Suarez, Dds Inc. | Dentist | 4606 Hollywood Blvd Ste A, Los Angeles, CA 90027-5462 | 2020-01-04 |
| 1831748839 | Slate Dental Corporation | Dentist | 6512 Lonetree Blvd Ste 100, Rocklin, CA 95765-5883 | 2019-09-11 |
| 1255980140 | Dr Maloux Macasaet Saguin Dental Corporation | Dentist | 9800 Topanga Canyon Blvd Ste J, Chatsworth, CA 91311-4075 | 2019-09-04 |
| 1891342267 | Amrollahie and Riman Dental Partnership | Dentist | 1442 Irvine Blvd Ste 225, Tustin, CA 92780-3846 | 2019-08-21 |
| 1548821572 | Hoang Dental Corporation | Dentist | 1356 W Valley Pkwy Ste J, Escondido, CA 92029-2138 | 2019-06-20 |
| 1073173860 | Omfs Care Center Partners | Dentist | 215 N Fresno St Ste 490, Fresno, CA 93701-0000 | 2019-06-14 |
| Find all providers with the same taxonomy | ||||
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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.