Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1407902307 Individual Practitioner Male Practitioner

Dr. Michael James Petersen , DDS

Dentist - General Practice • Roseville, MN

Professional Overview & Biography Verified Profile Summary

Dr. Michael Petersen, DDS is a registered healthcare professional specializing in Dentist - General Practice in Roseville, MN. Practice services are available at 3101 OLD HIGHWAY 8 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3101 Old Highway 8
Suite #303

Roseville, MN 551131072

Telephone 6516360840
Fax 6516331760
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Roseville, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 33.3 Yrs
Regional Practice Density
19 Specialists

Practicing in Roseville, MN (2262 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 - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MN 9923

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID (Incorporated)have Ind.#
(NEED TYPE 2 # ALSO) (MN)

Practice Associates & Co-Workers

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

3 Associated Practitioners
Dr. Lindsey Wolter , PharmD

Pharmacist - Psychiatric

NPI 1134848591

Doctor of Pharmacy (Pharm.D.)

NPI 1528384484

DVM, Doctor of Philosophy (Ph.D.), OMD, Licensed Acupuncturist

Emily Jamison , MSW, LICSW

Social Worker - Clinical

NPI 1831521806

Master of Social Work, Licensed Independent Clinical Social Worker

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 3101 OLD HIGHWAY 8, SUITE #303, ROSEVILLE, MN 551131072 (Tel: 6516360840)

📍
Updated Business Mailing Address July 08, 2007

Registered at 3101 OLD HIGHWAY 8, SUITE #303, ROSEVILLE, MN 551131072 (Tel: 6516360840)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as MICHAEL PETERSEN, D.D.S.

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

Dentist (License #9923 in MN)

🟢
Initial NPI Registration & Enumeration January 25, 2007

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: 1407902307
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 25, 2007
Last Update: July 08, 2007
Sole Proprietor: Yes

Mailing Address

3101 Old Highway 8, Suite #303

Roseville, MN 551131072

Phone: 6516360840

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.