DR. JEFFREY IAN PETERSEN (NPI# 1669454211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669454211 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY IAN PETERSEN |
| Credential | DMD |
| Practice Address |
2448 Guerneville Rd Santa Rosa CA 95403-4175 |
| Mailing Address |
91 Hop Ranch Rd Santa Rosa CA 95403-7528 |
| Practice Telephone | 7075792808 |
| Practice Fax Number | 7075792877 |
| Mailing Telephone | 7075792737 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
36313 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649312752 | Jeffrey Petersen | Internal Medicine | 300 Pasteur Dr # A175mc5309, Stanford, CA 94305-2200 | 2007-02-13 |
| 1912367251 | Jeffrey Petersen | Physical Therapist | 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 | 2016-02-29 |
| 1912330085 | Jeffrey Daniel Petersen | Counselor | 2655 Enterprise Rd, Reno, NV 89512-1666 | 2013-08-13 |
| 1184998585 | Jeffrey Ming Petersen | Pathology | 10833 Le Conte Ave, 13-145a Center for Hlth Sci, Los Angeles, CA 90095-3075 | 2012-03-02 |
| 1952543969 | Jeffrey W. Petersen | Specialist/Technologist | 308 S 3rd St, Watseka, IL 60970-1604 | 2009-04-06 |
| 1891977419 | Jeffrey Scott Petersen | Counselor | 500 Crown Point Cir, Grass Valley, CA 95945-9514 | 2007-12-05 |
| 1841389699 | Jeffrey Petersen | Physical Therapist | 1844 E Baseline Rd Ste C5, Tempe, AZ 85283-1506 | 2006-10-12 |
| 1699794735 | Jeffrey Petersen | Family Medicine | 1035 S Main Ave, Fallbrook, CA 92028-3338 | 2006-07-19 |
| 1275551707 | Jeffrey E Petersen | Dermatology | 1011 Bowles Ave, Suite 121, Fenton, MO 63026-2395 | 2006-07-17 |
| Street Address |
2448 GUERNEVILLE RD |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95403-4175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225569916 | Ian Petersen | Dentist | 2448 Guerneville Rd, Suite 200, Santa Rosa, CA 95403-4175 | 2017-03-23 |
| 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 | 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 |
|---|---|---|---|---|
| 1194369942 | M.s. Salek Dds, A Dental Corporation | Dentist | 2448 Guerneville Rd Ste 1000, Santa Rosa, CA 95403-7226 | 2019-11-05 |
| 1346806791 | Scott C. Bonin D.d.s. A Professional Denal Corporation | Dentist | 1260 N Dutton Ave Ste 290, Santa Rosa, CA 95401-7159 | 2019-05-11 |
| 1285035527 | Jeffers Dentistry Partnership | Dentist | 1820 Sonoma Ave Ste 42, Santa Rosa, CA 95405-6617 | 2014-09-05 |
| 1447699517 | Natalia Camacho-worms | Dentist | 1300 N. Dutton Ave, Santa Rosa, CA 95401 | 2013-06-21 |
| 1205170065 | Yunfei Fan Dds, A Professional Corporation | Dentist | 1420 Guerneville Rd Ste 5, Santa Rosa, CA 95403-4124 | 2012-11-19 |
| 1811231947 | Tingjen Ji | Dentist | 170 Farmers Ln Ste 1, Santa Rosa, CA 95405-4750 | 2012-11-15 |
| 1114295854 | James Klim | Dentist | 2755 Mendocino Ave, Suite 204, Santa Rosa, CA 95403-2827 | 2011-12-08 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| 1700029303 | Richard Anderson Dds | Dentist | 90 Doctors Park Drive, Santa Rosa, CA 95405-9998 | 2009-04-13 |
| 1356506596 | Kenneth James Bauer | Dentist | 55 Mission Cir Ste 107, Santa Rosa, CA 95409-5372 | 2008-07-28 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95403 |
Please comment or provide details below to improve the information on DR. JEFFREY 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.