Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Ian Petersen, DMD

Individual provider Dentist · NPI 1225569916

Dr. Ian Petersen, DMD is a Dentist in Santa Rosa, California. Licensed in California. Registered with an NPI since 2017.

Licensed in
CA
In the registry since
2017
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

2448 Guerneville Rd Ste 200
Santa Rosa, CA 95403-4175
Phone: (707) 579-2808
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 101238 (CA)

Record details

NPI number1225569916
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedMarch 23, 2017
Last updated in NPPESMarch 25, 2017

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