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

Dr. Kirk John Petersen, DMD

Individual provider Dentist · NPI 1285638106

Dr. Kirk John Petersen, DMD is a Dentist in Smith River, California. Licensed in California. Registered with an NPI since 2005.

Licensed in
CA
In the registry since
2005
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

501 N Indian Rd
Smith River, CA 95567-9509
Phone: (707) 487-0215
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 35534 (CA)

Record details

NPI number1285638106
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedJune 9, 2005
Last updated in NPPESMarch 3, 2018

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