DR. MICHELLE LYNN PETERSEN D.D.S. NPI 1063488047

NPI Information

NPI: 1063488047
Provider Name: DR. MICHELLE LYNN PETERSEN, D.D.S.
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
8010 STATE LINE RD
SUITE 210
PRAIRIE VILLAGE, KS
ZIP 66208
Phone: (913) 341-2200
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DR. Michelle Lynn Petersen, D.D.S. is a general practice dentist in Prairie Village, KS. The provider is 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. DR. Michelle Lynn Petersen, D.D.S. NPI is 1063488047. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

8010 STATE LINE RD
SUITE 210
PRAIRIE VILLAGE, KS
ZIP 66208-710
Phone: (913) 341-2200
Fax: (913) 648-7605

The enumeration date for this NPI number is 2/28/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	5735	KANSAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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