Family Dental Clinic
NPI 1629487897ActiveOrganization· Dentist· Prineville, OR
Dentist in Prineville, Oregon, registered in NPPES in August 2014. The authorized official on file is James G. Petersen, Owner/Dentist.
Overview
| NPI | 1629487897 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 12, 2014 |
| Last updated in NPPES | Aug 12, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | D10117 | OR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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