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MICHAEL J. PETERSEN, D.D.S., P.A.
NPI 1053935916
Clinic/Center - Dental in Roseville, MN

Active since June 05, 2020
3101 OLD HIGHWAY 8 STE 303, ROSEVILLE, MN 55113(651) 636-0840 Get Directions Write a Review

NPPES record last updated: June 5, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Michael J. Petersen, D.d.s., P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL J. PETERSEN, D.D.S., P.A. (NPI 1053935916) is a healthcare organization registered as a dental in Roseville, Minnesota and active in the NPI registry since June 2020. The organization lists Michael J. Petersen, Owner, Dentist, as its authorized official.

NPPES Registry Identity

NPI1053935916
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameMICHAEL J. PETERSEN, D.D.S., P.A.
Location Address3101 OLD HIGHWAY 8 STE 303Roseville, MN 55113-1076
Mailing Address3101 Old Highway 8 Ste 303Roseville, MN 55113-1076 · (651) 636-0840
Phone(651) 636-0840
Organization SubpartNo
Authorized OfficialMichael J. PetersenOwner, Dentist · (651) 636-0840
Enumeration DateJune 5, 2020
NPPES CertifiedJune 5, 2020
✔ NPI 1053935916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
3101 OLD HIGHWAY 8 STE 303, Roseville, MN 55113
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael J. Petersen, D.D.S., P.A.'s NPI number?

The NPI number for Michael J. Petersen, D.D.S., P.A. is 1053935916. It was assigned to this organization in the NPPES registry on June 5, 2020.

Where is Michael J. Petersen, D.D.S., P.A. located?

Michael J. Petersen, D.D.S., P.A. is located at 3101 Old Highway 8 Ste 303, Roseville, MN 55113. The listed phone number is (651) 636-0840.

What is Michael J. Petersen, D.D.S., P.A.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Michael J. Petersen, D.D.S., P.A. was last updated on June 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.