Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. SUSAN PETERSEN DMD
NPI 1912984352
Dentist - General Practice in Santa Rosa, CA

Q: What is Susan Petersen's NPI number?

The NPI number for Susan Petersen is 1912984352. It was assigned to this individual provider in the NPPES registry on December 28, 2005.

Q: What is Susan 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 Susan Petersen was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 28, 2005PECOS Enrolled

2448 GUERNEVILLE RD, STE 200, SANTA ROSA, CA 95403(707) 579-2808(707) 579-2877 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dr. Susan Petersen Dmd NPPES

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

DR. SUSAN PETERSEN DMD (NPI 1912984352) is an individual general practice provider in Santa Rosa, California, licensed in California (35667) and active in the NPI registry since December 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912984352

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameDR. SUSAN PETERSENCredential: DMD

Location Address2448 GUERNEVILLE RD, STE 200Santa Rosa, CA 95403-4175

Mailing Address91 Hop Ranch RdSanta Rosa, CA 95403-7528 · (707) 579-2737

Phone(707) 579-2808

Fax(707) 579-2877

Sole ProprietorNo

Enumeration DateDecember 28, 2005

Last NPPES UpdateJuly 13, 2026

✔ NPI 1912984352 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 · 35667

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.

2448 GUERNEVILLE RD, Santa Rosa, CA 95403

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Susan Petersen Dmd 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 95403 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

$96.16 typical visit price

range $63.04 – $187.01

Typical copayment $24.04 (range $15.76 – $46.75)

Most-billed visit code 99203

Established Patient

$77.94 typical visit price

range $21.02 – $153.40

Typical copayment $19.48 (range $5.25 – $38.35)

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.