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ANDREW M PETERSEN, DDS, LLC
NPI 1114189883
Dentist - General Practice in Phoenix, AZ

Active since June 25, 2008
4802 E RAY RD, SUITE #19, PHOENIX, AZ 85044(480) 893-7733 Get Directions Write a Review

NPPES record last updated: June 25, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Andrew M Petersen, Dds, Llc NPPES

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

ANDREW M PETERSEN, DDS, LLC (NPI 1114189883) is a healthcare organization registered as a general practice in Phoenix, Arizona and active in the NPI registry since June 2008. The organization lists Andrew Marvin Petersen, Owner, as its authorized official.

NPPES Registry Identity

NPI1114189883
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameANDREW M PETERSEN, DDS, LLC
Location Address4802 E RAY RD, SUITE #19Phoenix, AZ 85044-6405
Mailing Address4802 E Ray Rd, Suite #19Phoenix, AZ 85044-6405 · (480) 893-7733
Phone(480) 893-7733
Organization SubpartNo
Authorized OfficialAndrew Marvin PetersenOwner · (480) 893-7733
Enumeration DateJune 25, 2008
✔ NPI 1114189883 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in AZ · 7013
Definition
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.
4802 E RAY RD, Phoenix, AZ 85044
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GITA JAFARI-RASKE, M.D., PLLC
Internal Medicine
4802 E RAY RD, SUITE 23-534
PHOENIX, AZ 85044
Maricopa County (480) 926-0170
INNOVATIVE HEALTH PARTNERS LLC
Hospitalist
4802 E RAY RD, SUITE 23 PMB 289
PHOENIX, AZ 85044
Maricopa County (480) 343-2280
INNOVATIVE INPATIENT SERVICES, PC
Hospitalist
4802 E RAY RD, STE 23 PMB 289
PHOENIX, AZ 85044
Maricopa County (480) 343-2280

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 Andrew M Petersen, Dds, LLC's NPI number?

The NPI number for Andrew M Petersen, Dds, LLC is 1114189883. It was assigned to this organization in the NPPES registry on June 25, 2008.

Where is Andrew M Petersen, Dds, LLC located?

Andrew M Petersen, Dds, LLC is located at 4802 E Ray Rd Suite #19, Phoenix, AZ 85044. The listed phone number is (480) 893-7733.

What is Andrew M Petersen, Dds, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Andrew M Petersen, Dds, LLC was last updated on June 25, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.