P Praxis·MD
● Active Type 1 · Individual

DR. Alan Clark Peterson SR., D.M.D.

Dentist·Atlanta, GA· NPI 1174975429 · Enumerated 2016 · 9 years on NPI
Peterson is 1 of 7 dentist providers in Atlanta and 1 of 49 in Georgia.
NPI age
9 years
Enumerated 2016-07-11
Primary specialty
Dentist
Licensed in
MO
1 state
Status
Active
No deactivations on record
Last NPPES update
2016-07-11
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 49 active dentist providers in Georgia.

NPI age
9 years
↓ 10 yr below median (19 yr)
State licenses
1 state
4% of peers hold multiple states
Subspecialties
0
14% of peers hold subspecialties

NPI lifetime · 2016 → 2026

2016-07Enumerated in NPPES
2016 2026

Where they practice

Practice location
601 McDonough Blvd Se
Atlanta, GA 303154400
📞 4046355462
Mailing address
601 McDonough Blvd Se
Atlanta, GA 303154400
📞 4046355462

Specialties

  • Dentist Primary
    The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. ...
    MO license #015796 taxonomy 1223D0001X

Practice context

Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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