HALEY PETERSEN DDS
NPI 1689480782
Dentist - General Practice in San Leandro, CA

Q: What is Haley Petersen's NPI number?

The NPI number for Haley Petersen is 1689480782. It was assigned to this individual provider in the NPPES registry on December 4, 2024.

Q: What is Haley Petersen's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Haley Petersen was last updated on December 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.

Active since December 04, 2024PECOS Enrolled

3081 TEAGARDEN ST, SAN LEANDRO, CA 94577(510) 347-4620 Get Directions Write a Review

NPPES record last updated: December 4, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Haley Petersen Dds NPPES

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

HALEY PETERSEN DDS (NPI 1689480782) is an individual general practice provider in San Leandro, California, licensed in California (DDS110940) and active in the NPI registry since December 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689480782

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameHALEY PETERSENCredential: DDS

Location Address3081 TEAGARDEN STSan Leandro, CA 94577-5720

Mailing Address474 Vista CtBenicia, CA 94510-2716 · (707) 334-4221

Phone(510) 347-4620

Sole ProprietorNo

Enumeration DateDecember 4, 2024

NPPES CertifiedDecember 3, 2024

✔ NPI 1689480782 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CA · DDS110940

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.

3081 TEAGARDEN ST, San Leandro, CA 94577

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Haley Petersen Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94577 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$84.91 typical visit price

range $23.44 – $166.46

Typical copayment $21.22 (range $5.86 – $41.61)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

DEVONNA JACOBS

Counselor