DR. JORDAN PETERSCHMIDT (NPI# 1528444163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528444163 |
| Entity Type | Individual |
| Full Name | DR. JORDAN PETERSCHMIDT |
| Credential | DMD |
| Practice Address |
470 Glen Creek Rd Nw Salem OR 97304-3060 |
| Mailing Address |
Po Box 8021 Salem OR 97303-0224 |
| Practice Telephone | 5419053816 |
| Mailing Telephone | 5419053816 |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2015-08-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D10308 | OR | Dental Providers |
| Street Address |
470 GLEN CREEK RD NW |
| City | SALEM |
| State | OR |
| Zip Code | 97304-3060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710965611 | James Edward Shelton | Dentist | 470 Glen Creek Rd Nw, Suite 100, Salem, OR 97304-3060 | 2006-01-03 |
| 1861719270 | Sharon L. Crawford | Dental Hygienist | 470 Glen Creek Rd Nw, Suite 100, Salem, OR 97304-3060 | 2010-04-24 |
| 1235334012 | Glen Creek Dental LLC | Dentist | 470 Glen Creek Rd Nw, Suite 100, Salem, OR 97304-3060 | 2007-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114413010 | Sam Mackenzie Lane | Massage Therapist | 1661 Edgewater St Nw # 120, Salem, Or 97304, Salem, OR 97304 | 2018-07-03 |
| 1144761131 | Rachel E Carson | Physical Therapist | 1025 2nd St. Nw, West Salem, OR 97304 | 2017-03-10 |
| 1962951061 | Lee Ann Nail | Social Worker | 3965 Gibson Rd Nw, Salem, OR 97304 | 2016-09-29 |
| 1619421591 | Logan Walters | Physical Therapist | 1025 2nd St Nw, Salem, OR 97304 | 2016-08-09 |
| 1770941338 | Tysandra Gillis | Massage Therapist | 859 Mule Deer St., Salem, OR 97304 | 2016-02-10 |
| 1144620295 | Molly Rodden | Nurse Practitioner | 1174 Cornucopia St Nw Ste 240, Salem, OR 97304 | 2014-08-26 |
| 1881942126 | Cynthia Ruth Rettler | Registered Nurse | 1520 Plaza St Nw Ste 150, Salem, OR 97304 | 2012-08-16 |
| 1336401017 | Trillium Family Services | Community/Behavioral Health | 1520 Plaza Street Nw, Suite 100, Salem, OR 97304 | 2012-06-08 |
| 1033428198 | Kathleen Ketelson | Nurse Practitioner | 560 Wallace Rd Nw Ste 140, Salem, OR 97304 | 2010-10-06 |
| 1922332535 | Robert Scott Mcadam | Social Worker | 1245 Edgewater St. Nw, Salem, OR 97304 | 2009-09-29 |
| Find all providers in zip 97304 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811537665 | My Smile Experience P.C. | Dentist | 99 Rockingham Park Blvd # W111b, Salem, NH 03079-2900 | 2020-01-09 |
| 1861047532 | Kathy Trinh | Dentist | 1920 Turner Rd Se, Suite B, Salem, OR 97302-2003 | 2019-08-08 |
| 1699266981 | Morgan Nicole Shivers | Dentist | 2951 Oh-45, Salem, OH 44460 | 2018-05-23 |
| 1730684937 | Eva Chiu | Dentist | 142a Canal St, Salem, MA 01970-4650 | 2018-03-28 |
| 1952825762 | Matthew Paul Martin | Dentist | 2737 Lancaster Dr Ne Ste 150, Salem, OR 97305 | 2017-08-02 |
| 1942652557 | Karin Arsenault | Dentist | 32 Stiles Rd Ste 208, Salem, NH 03079-2894 | 2016-07-07 |
| 1811391527 | Hala Mahmod | Dentist | 4 Lancelot Ct Apt 15, Salem, NH 03079-3529 | 2014-10-09 |
| 1871907139 | Pure Dental PC | Dentist | 3470 Pipebend Pl Ne Ste 110, Salem, OR 97301-1741 | 2014-06-16 |
| 1669811071 | Stephanie Nicole Vlahos | Dentist | 1930 Braeburn Dr Ste A, Salem, VA 24153-7391 | 2013-06-19 |
| 1568705168 | Alfred Joseph Sotera | Dentist | 12 Stiles Road, Suite 206, Salem, NH 03079-2881 | 2013-04-02 |
| Find all providers in SALEM | ||||
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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.