ERIC L PETERSON DDS PC NPI 1639165384

NPI Information

  • NPI: 1639165384
  • Provider Name: ERIC L PETERSON DDS PC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 225 SCOTTWOOD AVE
    ELMIRA HEIGHTS, NY
    ZIP 14903
  • Phone: (607) 733-3616

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NPI Details

ERIC L PETERSON DDS PC is a general practice dentist in Elmira Heights, NY. 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. ERIC L PETERSON DDS PC NPI is 1639165384. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

225 SCOTTWOOD AVE
ELMIRA HEIGHTS, NY
ZIP 14903-322
Phone: (607) 733-3616
Fax: (607) 733-1053

The provider's authorized official is Eric Laurence Peterson .
The authorized official title is President and has the following contact phone number (607) 733-3616.

The enumeration date for this NPI number is 9/27/2005 and was last updated on 8/22/2020.

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 Practice049002NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
102169271MEDICAIDNEW YORK

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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