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Deactivated NPI 1902025265 Deactivated / Inactive NPI Male Practitioner

Dr. John David Peterson , DDS

Dentist - General Practice • Fremont, OH

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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 Peterson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 25, 2007
NPI Deactivation Date September 27, 2023
Total Practice Duration ~16 Years of Practice (2007 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. John Peterson, DDS was a registered Dentist - General Practice practicing in Fremont, OH. Throughout an active medical career spanning 16 years, Dr. Peterson provided care at the practice location at 215 JUSTICE ST until profile deactivation on 2023-09-27.

Practice Location & Contact Primary Location

Practice Address

215 Justice St

Fremont, OH 434202420

Telephone 4193343744
Fax 4193323524

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Fremont, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.6 Yrs
Regional Practice Density
13 Specialists

Practicing in Fremont, OH (4287 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 OH 12536

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

1 Associated Practitioners
Dr. Andrew Peterson , DDS

Dentist - General Practice

NPI 1326184953

Doctor of Dental Surgery

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 27, 2023

Record deactivated on September 27, 2023

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 215 JUSTICE ST, FREMONT, OH 434202420 (Tel: 4193343744)

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Updated Business Mailing Address July 08, 2007

Registered at 215 JUSTICE ST, FREMONT, OH 434202420 (Tel: 4193343744)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JOHN PETERSON, D.D.S.

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

Dentist (License #12536 in OH)

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Initial NPI Registration & Enumeration April 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: 1902025265
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 25, 2007
Last Update: July 08, 2007
Deactivation Date: September 27, 2023

Mailing Address

215 Justice St

Fremont, OH 434202420

Phone: 4193343744

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.