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Active NPI 1295846376 Organization (Entity Type 2)

Dean B Petterson Dmd Pc

Dentist - General Practice • Gresham, OR

About Dean B Petterson Dmd Pc NPI 1295846376 Summary

Dean B Petterson Dmd Pc is a verified healthcare organization specializing in Dentist - General Practice operating in Gresham, OR. Located at 121 NW 1ST ST, this facility provides patient care and medical services under National Provider Identifier (NPI) 1295846376.

Administrative operations and authorized compliance are overseen by Dean Petterson (Owner).

Facility Location & Contact Primary Location

Facility Address

121 Nw 1st St

Gresham, OR 970307215

Telephone 5036671001
Fax 5036633500

Authorized Official Information

Authorized Contact Name

DR. Dean Petterson , DMD

Title / Role

Owner

Official Telephone

5036671001

Facility Classifications & Specialties

Dentist - General Practice Primary Taxonomy

NUCC Taxonomy Code: 1223G0001X

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.

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events
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 121 NW 1ST ST, GRESHAM, OR 970307215 (Tel: 5036671001)

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Updated Business Mailing Address July 08, 2007

Registered at 121 NW 1ST ST, GRESHAM, OR 970307215 (Tel: 5036671001)

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Organization / Clinic Name Updated July 08, 2007

Operating as DEAN B PETTERSON DMD PC

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

Dentist

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Initial NPI Registration & Enumeration August 31, 2006

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

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NPI Organization Metadata

NPI Number: 1295846376
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: August 31, 2006
Last Update: August 22, 2020

Mailing Address

121 Nw 1st St

Gresham, OR 970307215

Phone: 5036671001

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.