OrganizationActive
Andrew M Petersen, DDS, LLC
NPI 1114189883 · General Practice Dentistry · Phoenix, AZ
Provider details
- NPI number
- 1114189883
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Andrew Petersen, Owner(480) 893-7733
- License
- 7013 (AZ)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 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
4802 E Ray Rd
Suite #19
Phoenix, AZ 85044-6405
Phone: (480) 893-7733
Street-level locationGet directions
Mailing address
4802 E Ray Rd
Phoenix, AZ 85044-6405
Registry dates
- Enumerated
- 2008-06-25
- Last updated
- 2008-06-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.