Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Andrew M Petersen, DDS, LLC

Organization General Practice Dentistry · NPI 1114189883

Andrew M Petersen, DDS, LLC provides General Practice Dentistry in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2008.

Licensed in
AZ
In the registry since
2008
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4802 E Ray Rd Ste #19
Phoenix, AZ 85044-6405 Not confirmed with CMS for 18 years — call before visiting
Phone: (480) 893-7733
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 7013 (AZ)

Record details

NPI number1114189883
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrew Petersen — Owner · (480) 893-7733
NPI enumeratedJune 25, 2008
Last updated in NPPESJune 25, 2008
Mailing address4802 E Ray Rd, Suite #19, Phoenix, AZ 85044-6405

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