Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1053321497 Individual Practitioner Male Practitioner

Dr. Kenneth L Peterson , DMD

Dentist - General Practice • John Day, OR

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Peterson, DMD is a registered healthcare professional specializing in Dentist - General Practice in John Day, OR. Practice services are available at 165 NW 1ST AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

165 Nw 1st Ave

John Day, OR 978451101

Telephone 5415750363

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in John Day, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.7 Yrs
Regional Practice Density
3 Specialists

Practicing in John Day, OR (1994 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 OR 3986

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. James Klusmier , DDS

Dentist - General Practice

NPI 1356360044

Doctor of Dental Surgery

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 165 NW 1ST AVE, JOHN DAY, OR 978451101 (Tel: 5415750363)

📍
Updated Business Mailing Address July 08, 2007

Registered at 165 NW 1ST AVE, JOHN DAY, OR 978451101 (Tel: 5415750363)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as KENNETH PETERSON, D.M.D.

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

Dentist (License #3986 in OR)

🟢
Initial NPI Registration & Enumeration August 08, 2006

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: 1053321497
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 08, 2006
Last Update: July 08, 2007
Sole Proprietor: Yes

Mailing Address

165 Nw 1st Ave

John Day, OR 978451101

Phone: 5415750363

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.