DR. JOHN ROBERT PETERSEN DDS NPI 1508422411

NPI Information

  • NPI: 1508422411
  • Provider Name: DR. JOHN ROBERT PETERSEN, DDS
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • Address: 4555 ERIN DR
    EAGAN, MN
    ZIP 55122
  • Phone: (651) 681-9044

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NPI Details

DR. John Robert Petersen, DDS is a general practice dentist in Eagan, MN. 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. John Robert Petersen, DDS NPI is 1508422411. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4555 ERIN DR
EAGAN, MN
ZIP 55122-398
Phone: (651) 681-9044
Fax: (651) 681-0599

The enumeration date for this NPI number is 5/15/2019 and was last updated on 5/15/2019.

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
11223G0001XDentistGeneral PracticeD13993MINNESOTAYes

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: 11/21/2025

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