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Deactivated NPI 1114025293 Deactivated / Inactive NPI Male Practitioner

Dr. Peter Ristuben , DDS

Dentist - General Practice • Snoqualmie, WA

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

Registration / Start Date September 20, 2006
NPI Deactivation Date January 02, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Peter Ristuben, DDS was a registered Dentist - General Practice practicing in Snoqualmie, WA. Throughout an active medical career spanning 19 years, Dr. Ristuben provided care at the practice location at 38475 SE RIVER ST until profile deactivation on 2025-01-02.

Practice Location & Contact Primary Location

Practice Address

38475 Se River St

Snoqualmie, WA 980659658

Telephone 4258882684
Fax 4258312118
Associated Practice Facility / Clinic
🏢 Snoqualmie Family Dentistry Facility NPI 1548716830

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Snoqualmie, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.3 Yrs
Regional Practice Density
4 Specialists

Practicing in Snoqualmie, WA (3345 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 WA DE00006388

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. Anna Lee , DDS

Dentist - General Practice

NPI 1548368616

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 January 02, 2025

Record deactivated on January 02, 2025

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 38475 SE RIVER ST, SNOQUALMIE, WA 980659658 (Tel: 4258882684)

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Updated Business Mailing Address July 08, 2007

Registered at PO BOX 1952, SNOQUALMIE, WA 980651952 (Tel: 4258882684)

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Provider Name / Credentials Updated July 08, 2007

Recorded as PETER RISTUBEN, D.D.S.

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

Dentist (License #DE00006388 in WA)

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Initial NPI Registration & Enumeration September 20, 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: 1114025293
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 20, 2006
Last Update: July 08, 2007
Deactivation Date: January 02, 2025

Mailing Address

Po Box 1952

Snoqualmie, WA 980651952

Phone: 4258882684

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.