DR. MICHAEL JAMES PETERSEN (NPI# 1407902307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407902307 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL JAMES PETERSEN |
| Credential | D.D.S. |
| Practice Address |
3101 Old Highway 8 Suite #303 Roseville MN 55113-1072 |
| Practice Telephone | 6516360840 |
| Practice Fax Number | 6516331760 |
| Mailing Telephone | 6516360840 |
| Mailing Fax Number | 6516331760 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
9923 | MN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | (INCORPORATED)HAVE IND.# | (NEED TYPE 2 # ALSO) | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740602960 | Michael Petersen | Veterinarian | 5754 Nicollet Ave, Minneapolis, MN 55419-2415 | 2014-01-07 |
| 1881798379 | Michael Charles Petersen | Pediatrics | 12356 Riata Trace Pkwy # 6006-b, Austin, TX 78727-6417 | 2006-09-12 |
| 1629005160 | Michael R Petersen | Ophthalmology | 2000 N Huron River Dr Ste 100, Ypsilanti, MI 48197 | 2006-06-28 |
| 1467428656 | Michael S Petersen | Orthopaedic Surgery | 2020 Sutter Pl, Suite 104, Davis, CA 95616-6213 | 2006-02-27 |
| 1609849736 | Michael T Petersen | Anesthesiology | 25 Main Pl, Suite 425, Council Bluffs, IA 51503-0792 | 2006-02-09 |
| 1639785579 | Michael Lee Petersen | Pharmacist | 900 W Clairemont Ave, Eau Claire, WI 54701-6122 | 2020-09-16 |
| 1780248146 | Michael Jake Petersen | Student in an Organized Health Care Education/Training Program | 600 S Paulina St Ste 403, Chicago, IL 60612-3806 | 2019-04-30 |
| 1093182552 | Michael Petersen | Counselor | 1067 E Tabernacle St, Suite 7, Saint George, UT 84770-3163 | 2015-08-31 |
| 1972746931 | Michael G Petersen | Physician Assistant | 7201 Manchaca Rd, Ste B, Austin, TX 78745-5283 | 2009-04-07 |
| 1518974153 | Michael J Petersen | Podiatrist | 3922 Mercy Dr, Mchenry, IL 60050-3151 | 2006-08-02 |
| Street Address |
3101 OLD HIGHWAY 8 SUITE #303 |
| City | ROSEVILLE |
| State | MN |
| Zip Code | 55113-1072 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083163745 | Andrya Dieter, Psyd, Lp, LLC | Community/Behavioral Health | 3101 Old Highway 8, Suite 304b, Roseville, MN 55113-1072 | 2016-09-22 |
| 1447620950 | Nicole Klersy-mohr | Chiropractor | 3101 Old Highway 8, 300, Roseville, MN 55113-1072 | 2015-09-28 |
| 1548639586 | Perfect Touch Massage & Chiropractic, Ltd | Chiropractor | 3101 Old Highway 8, Suite 300, Roseville, MN 55113-1072 | 2015-09-21 |
| 1548564511 | Genoa Healthcare Clinical Laboratory LLC | Clinical Medical Laboratory | 3101 Old Highway 8, Suite 203-a, Roseville, MN 55113-1072 | 2011-01-05 |
| 1528384484 | Keumhwa Choi | Acupuncturist | 3101 Old Highway 8, Suite Number 104, Roseville, MN 55113-1072 | 2010-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| 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 |
|---|---|---|---|---|
| 1770196891 | Thomas J Hoeffel Dds Pa | Dentist | 2819 Hamline Ave N Ste 104, Roseville, MN 55113-7718 | 2020-08-28 |
| 1023654381 | Daniel Fernando Reyes Sighinolfi | Dentist | 3281 Rock Creek Way, Roseville, CA 95747-7155 | 2019-11-21 |
| 1053963033 | Convenient Rv PC | Dentist | 19551 E. 10 Mile Rd, Roseville, MI 48066 | 2019-07-10 |
| 1114586203 | Cam Ha | Dentist | 17367 Kershaw St, Roseville, MI 48066-3345 | 2019-06-11 |
| 1861910705 | Rss Laurie Strand Pllc | Dentist | 2375 Fairview Ave N, Roseville, MN 55113-2707 | 2017-08-30 |
| 1326562752 | Fernando Lopez Vargas | Dentist | 4000 Foothills Blvd Ste 126, Roseville, CA 95747-7251 | 2017-07-27 |
| 1942743182 | Sarang Dehghan | Dentist | 3245 Halverson Way, Roseville, CA 95661-4039 | 2016-11-20 |
| 1053760587 | Maichou Yang | Dentist | 700 Sunrise Ave Ste E, Roseville, CA 95661-4561 | 2016-06-06 |
| 1093178055 | Sonny Afshar Dds Inc | Dentist | 2030 Douglas Blvd, Suite 37, Roseville, CA 95661-3855 | 2016-03-29 |
| 1326449984 | Hamzah Alkordy | Dentist | 2424 Professional Dr, Roseville, CA 95661-7773 | 2014-09-14 |
| Find all providers in ROSEVILLE | ||||
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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.