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

Dr. John Robert Petersen, DDS

Individual provider General Practice Dentistry · NPI 1508422411

Dr. John Robert Petersen, DDS is a General Practice Dentistry in Eagan, Minnesota. Licensed in Minnesota. Registered with an NPI since 2019.

Licensed in
MN
In the registry since
2019
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

4555 Erin Dr
Eagan, MN 55122-3398
Phone: (651) 681-9044
Fax: (651) 681-0599
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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 D13993 (MN)

Record details

NPI number1508422411
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedMay 15, 2019
Last updated in NPPESMay 15, 2019
Mailing address3200 Hilldale Ave Ne, St Anthony, MN 55418-2502

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