Dr. John Robert Petersen, DDS
Dr. John Robert Petersen is a General Practice Dentistry provider (Dentist) practicing in Eagan, MN, registered in the NPPES registry with NPI 1508422411 since 2019. The credential DDS stands for Doctor of Dental Surgery.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1508422411 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Dr. John Robert Petersen |
| Credential | DDS |
| Sex | Male |
| Practice address | 4555 ERIN DR, Eagan, MN, 55122 |
| Phone | 6516819044 |
| Fax | 6516810599 |
| Enumeration date | 2019-05-15 |
| Last updated in NPPES | 2019-05-15 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 1223G0001X | General Practice Dentistry | Primary | D13993 | MN |
DDS — Doctor of Dental Surgery: A licensed dentist; DDS and DMD are equivalent dental degrees. About the DDS credential
Copy-ready billing details
Provider: John Petersen, DDS NPI: 1508422411 Taxonomy: 1223G0001X (General Practice Dentistry) Address: 4555 ERIN DR, Eagan, MN, 55122
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1326048422 | Linda Raasch | Individual | Psychologist | Eagan, MN |
| 1194707869 | Lyndall Johnson | Individual | Psychologist | Eagan, MN |
| 1447238381 | Colin Hollidge | Individual | Social Worker | Eagan, MN |
| 1649371063 | John Mittelsteadt | Individual | General Practice Dentistry | Eagan, MN |
| 1629135819 | Brandon Mannie D.C. LLC | Organization | Chiropractor | Eagan, MN |
| 1376690529 | Aslan Institute | Organization | Psychologist | Eagan, MN |
| 1063620276 | Nancy Cohen | Individual | Marriage & Family Therapist | Eagan, MN |
| 1902146335 | Eagan Valley Dental Center P.A. | Organization | Dentist | Eagan, MN |
Verify this record
Cross-check NPI 1508422411 against the authoritative CMS record: view Dr. John Robert Petersen on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2019-05-15.