Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1285638106 Individual Practitioner Male Practitioner

Dr. Kirk John Petersen , DMD

Dentist • Smith River, CA

Professional Overview & Biography Verified Profile Summary

Dr. Kirk Petersen, DMD is a registered healthcare professional specializing in Dentist in Smith River, CA. Practice services are available at 501 N INDIAN RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

501 N Indian Rd

Smith River, CA 955679509

Telephone 7074870215
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Smith River, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
3 Specialists

Practicing in Smith River, CA (15331 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License CA 35534

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
NPI 1518157866

Doctor of Dental Surgery

Chad Gagnon , PA-C

Physician Assistant - Medical

NPI 1568460665

Physician Assistant (Certified)

Carolyn Arellanes , PA

Physician Assistant

NPI 1659501880

Physician Assistant

Lana Dreyfuss , LPCC LCADC LPC HTR

Psychologist - Counseling

NPI 1679914428

LPCCLCADCLPCHTR

NPI 1881214203

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
NPI Profile Active March 03, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location March 03, 2018

Registered at 501 N INDIAN RD, SMITH RIVER, CA 955679509 (Tel: 7074870215)

📍
Updated Business Mailing Address March 03, 2018

Registered at 1301 S PEBBLE BEACH DR, CRESCENT CITY, CA 955313339 (Tel: 9512652240)

👤
Provider Name / Credentials Updated March 03, 2018

Recorded as KIRK PETERSEN, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 03, 2018

Dentist (License #35534 in CA)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 3232 W FLORIDA AVE, HEMET, CA 925453622 (Tel: 9516524464)

📍
Updated Business Mailing Address July 08, 2007

Registered at 3232 W FLORIDA AVE, HEMET, CA 925453622 (Tel: 9516524464)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as KIRK PETERSEN, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #35534 in CA)

🟢
Initial NPI Registration & Enumeration June 09, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1285638106
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 09, 2005
Last Update: March 03, 2018
Sole Proprietor: No

Mailing Address

1301 S Pebble Beach Dr

Crescent City, CA 955313339

Phone: 9512652240

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.