Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1275849986 Individual Practitioner Male Practitioner

Dr. Kyle Pettersen , DDS

Dentist - General Practice • Palm Springs, FL

Professional Overview & Biography Verified Profile Summary

Dr. Kyle Pettersen, DDS is a registered healthcare professional specializing in Dentist - General Practice in Palm Springs, FL. Practice services are available at 3401 S CONGRESS AVE STE 206 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3401 S Congress Ave Ste 206

Palm Springs, FL 334613066

Telephone 5613662222
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Palm Springs, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.0 Yrs
Regional Practice Density
15 Specialists

Practicing in Palm Springs, FL (7473 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

CMS Verified: 2026-04-19
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License GA DN016137

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.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License CA 59547

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.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License TX 0025983

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.

Practice Associates & Co-Workers

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

2 Associated Practitioners
NPI 1215396882
Dr. Harrison Hodgman , DDS

Dentist - Pediatric Dentistry

NPI 1396223392

Doctor of Dental Surgery

Career & Practice History Timeline

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

12 Historical Events
📍
Updated Practice Location April 19, 2026

Registered at 3401 S CONGRESS AVE STE 206, PALM SPRINGS, FL 334613066 (Tel: 5613662222)

📍
Updated Business Mailing Address April 19, 2026

Registered at 3401 S CONGRESS AVE STE 206, PALM SPRINGS, FL 334613066 (Tel: 5613662222)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 19, 2026

Dentist (License #59547 in CA)

📍
Updated Practice Location March 26, 2021

Registered at 609 BEAVER RUIN RD NW # A, LILBURN, GA 300473401 (Tel: 6786069407)

📍
Updated Business Mailing Address March 26, 2021

Registered at 207 13TH ST NE APT 2306, ATLANTA, GA 303094611 (Tel: 5617153397)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 26, 2021

Dentist (License #DN016137 in GA)

NPI Profile Active October 11, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location October 11, 2013

Registered at 6735 YUCCA ST UNIT 309, LOS ANGELES, CA 900284659 (Tel: 5617153397)

📍
Updated Business Mailing Address October 11, 2013

Registered at 6735 YUCCA ST UNIT 309, LOS ANGELES, CA 900284659 (Tel: 5617153397)

👤
Provider Name / Credentials Updated October 11, 2013

Recorded as KYLE PETTERSEN, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 11, 2013

Dentist (License #59547 in CA)

🟢
Initial NPI Registration & Enumeration August 19, 2010

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: 1275849986
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 19, 2010
Last Update: April 19, 2026
Sole Proprietor: Yes

Mailing Address

3401 S Congress Ave Ste 206

Palm Springs, FL 334613066

Phone: 5613662222

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.