MEDICARE: DR. DANE M PETERSON OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2738	CO
2	152W00000X	Optometrist	3325	MN

General Provider Information

NPI Number	:	1285863530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANE M PETERSON OD

Provider Business Mailing Address
First Line	:	8401 GOLDEN VALLEY RD STE 330
Second Line	:
City	:	GOLDEN VALLEY
State	:	MN
Zip	:	55427-4488
Country	:	US
Telephone Number	:	763-416-7629
Fax Number	:	763-383-4147

Provider Business Practice Location Address
First Line	:	2601 39TH AVE NE STE 1
Second Line	:
City	:	ST. ANTHONY
State	:	MN
Zip	:	55421-4372
Country	:	US
Telephone Number	:	763-416-7600
Fax Number	:	763-416-7634

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2009
Last Update Date	:	03/17/2020

Similar Medicare Providers

1053347179 — SILVER LAKE CLINIC
Practice Location Address:

2600 39TH AVE NE
ST ANTHONY, MN
55421-4372

Practice Phone: 612-706-2900
Practice Fax: 612-706-2901

1003882150 — DR. KAJAL DASGUPTA M.D.
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-2424
Practice Fax:

1881646115 — MS. MELISSA RYAN STRAUSS P.A.
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-2424
Practice Fax:

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1083683437 — LARRY WAYNE ERICKSON DDS
Practice Location Address:

4001 STINSON BLVD NE , SUITE 414
ST. ANTHONY, MN
55421

Practice Phone: 612-789-7888
Practice Fax: 612-789-7889

Directions to “ DR. DANE M PETERSON OD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.