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Deactivated NPI 1114167434 Deactivated / Inactive NPI Male Practitioner

Dr. John Seigfred Petersen , DDS

Dentist - General Practice • Whitefish, MT

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. John Petersen has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 26, 2009
NPI Deactivation Date September 08, 2020
Total Practice Duration ~11 Years of Practice (2009 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. John Petersen, DDS was a registered Dentist - General Practice practicing in Whitefish, MT. Throughout an active medical career spanning 11 years, Dr. Petersen provided care at the practice location at 415 CENTRAL AVE until profile deactivation on 2020-09-08.

Practice Location & Contact Primary Location

Practice Address

415 Central Ave

Whitefish, MT 599372770

Telephone 4068625996

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Whitefish, MT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.9 Yrs
Regional Practice Density
8 Specialists

Practicing in Whitefish, MT (489 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 MT 1217

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.

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated September 08, 2020

Record deactivated on September 08, 2020

NPI Profile Active February 26, 2009

NPI status registered as active in NPPES database

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Updated Practice Location February 26, 2009

Registered at 415 CENTRAL AVE, WHITEFISH, MT 599372770 (Tel: 4068625996)

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Updated Business Mailing Address February 26, 2009

Registered at 415 CENTRAL AVE, WHITEFISH, MT 599370038 (Tel: 4068625996)

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Provider Name / Credentials Updated February 26, 2009

Recorded as JOHN PETERSEN, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 26, 2009

Dentist (License #1217 in MT)

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Initial NPI Registration & Enumeration February 26, 2009

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: 1114167434
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 26, 2009
Last Update: February 26, 2009
Deactivation Date: September 08, 2020

Mailing Address

415 Central Ave

Whitefish, MT 599370038

Phone: 4068625996

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.