Carly Christoferson Petersen, DMD

General Practice Dentistry · Lake Oswego, OR

Individual Active NPI

NPI number 1841844354

Practice location

3900 Douglas Way
Lake Oswego, OR 97035-3446
Phone
(503) 636-8446
Fax
(503) 636-4446

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NPI record

NPI
1841844354
Entity type
Individual (Type 1)
Enumeration date
August 1, 2019
Last updated
March 1, 2022
Certified
March 1, 2022
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X D11110 OR

About Dr. Petersen

Carly Christoferson Petersen, DMD is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 3900 Douglas Way, Lake Oswego, OR 97035-3446. The NPI number 1841844354 was assigned on August 1, 2019 and the record was last updated on March 1, 2022.

Dr. Petersen lists a license in the registry: #D11110 (OR) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Carly Christoferson Petersen, DMD?

The NPI number is 1841844354.

What is the phone number of Dr. Petersen?

The phone number listed for the practice location is (503) 636-8446.

Where is Dr. Petersen located?

3900 Douglas Way, Lake Oswego, OR 97035-3446.

What is the taxonomy code for Dr. Petersen?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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