DR. CARLY CHRISTOFERSON PETERSEN DMD - NPI 1841844354

Q: What is the provider's specialty?

The provider's specialty is Dentist with taxonomy code 1223G0001X and a focus in General Practice.

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About Dr. Carly Christoferson Petersen Dmd NPPES

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

DR. CARLY CHRISTOFERSON PETERSEN DMD (NPI 1841844354) is an individual general practice provider in Lake Oswego, Oregon, licensed in Oregon (D11110) and active in the NPI registry since August 2019.

NPPES Registry Identity

NPI1841844354

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameDR. CARLY CHRISTOFERSON PETERSENCredential: DMD

Location Address3900 DOUGLAS WAYLake Oswego, OR 97035-3446

Mailing Address3900 Douglas WayLake Oswego, OR 97035-3446 · (503) 636-8446 · Fax (503) 636-4446

Phone(503) 636-8446

Fax(503) 636-4446

Sole ProprietorYes

Enumeration DateAugust 1, 2019

Last NPPES UpdateMarch 1, 20222 updates tracked since enumeration

NPPES CertifiedMarch 1, 2022

✔ NPI 1841844354 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in OR · D11110

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.

3900 DOUGLAS WAY, Lake Oswego, OR 97035

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›