Michael J. Petersen, D.D.S., P.A.
NPI 1053935916 · Dental Clinic/Center · Roseville, MN
Michael J. Petersen, D.D.S., P.A. is a Dental Clinic/Center organization in Roseville, MN (NPI 1053935916).
Provider details
- NPI number
- 1053935916
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Michael Petersen, Owner, Dentist(651) 636-0840
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2020-06-05
- Last updated
- 2020-06-05
- Certified
- 2020-06-05
Frequently asked questions
- What is Michael J. Petersen, D.D.S., P.A.'s NPI number?
- Michael J. Petersen, D.D.S., P.A.'s National Provider Identifier (NPI) is 1053935916, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Michael J. Petersen, D.D.S., P.A.?
- Michael J. Petersen, D.D.S., P.A. is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Michael J. Petersen, D.D.S., P.A. located?
- Michael J. Petersen, D.D.S., P.A.'s practice location on file with NPPES is 3101 Old Highway 8 Ste 303, Roseville, MN 55113-1076.
- What is Michael J. Petersen, D.D.S., P.A.'s phone number?
- The practice phone number listed in the NPPES registry for Michael J. Petersen, D.D.S., P.A. is (651) 636-0840.
- Who is the authorized official for Michael J. Petersen, D.D.S., P.A.?
- The authorized official listed on Michael J. Petersen, D.D.S., P.A.'s NPPES record is Michael Petersen, Owner, Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Michael J. Petersen, D.D.S., P.A.'s NPI active?
- Yes — Michael J. Petersen, D.D.S., P.A.'s NPI (1053935916) is active in the NPPES registry as of the last update on 2020-06-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.