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Deactivated NPI 1780682526 Deactivated / Inactive NPI Female Practitioner

Dr. Candace L Peterson , DMD

Dentist - General Practice • Tualatin, OR

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

Registration / Start Date July 13, 2005
NPI Deactivation Date March 17, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Candace Peterson, DMD was a registered Dentist - General Practice practicing in Tualatin, OR. Throughout an active medical career spanning 1 years, Dr. Peterson provided care at the practice location at 18795 SW BOONES FERRY RD until profile deactivation on 2006-03-17.

Practice Location & Contact Primary Location

Practice Address

18795 Sw Boones Ferry Rd

Tualatin, OR 970628412

Telephone 5036919046
Fax 5036927229

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Tualatin, OR

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

Practicing in Tualatin, 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 6101

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. Amy Trevor , DMD

Dentist - General Practice

NPI 1275960296

Doctor of Dental Medicine

Career & Practice History Timeline

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

7 Historical Events
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Updated Practice Location March 04, 2015

Registered at 18795 SW BOONES FERRY RD, TUALATIN, OR 970628412 (Tel: 5036919046)

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Updated Business Mailing Address March 04, 2015

Registered at 18795 SW BOONES FERRY RD, TUALATIN, OR 970626807 (Tel: 5036919046)

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Provider Name / Credentials Updated March 04, 2015

Recorded as CANDACE PETERSON, DMD

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 04, 2015

Dentist (License #6101 in OR)

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NPI Profile Reactivated March 27, 2006

Record officially reactivated for active practice on March 27, 2006

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NPI Profile Deactivated March 17, 2006

Record deactivated on March 17, 2006

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Initial NPI Registration & Enumeration July 13, 2005

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: 1780682526
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 13, 2005
Last Update: March 04, 2015
Deactivation Date: March 17, 2006
Sole Proprietor: Yes

Mailing Address

18795 Sw Boones Ferry Rd

Tualatin, OR 970626807

Phone: 5036919046

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.