Provider Demographics
NPI:1982910907
Name:FRANDSEN, PETER SHIGEKI (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:SHIGEKI
Last Name:FRANDSEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7321 BALMER STREET BLDG #570
Mailing Address - Street 2:HILL AFB, 75TH MDG/SGD
Mailing Address - City:HILL AFB
Mailing Address - State:UT
Mailing Address - Zip Code:84056
Mailing Address - Country:US
Mailing Address - Phone:801-777-7011
Mailing Address - Fax:801-777-0590
Practice Address - Street 1:7321 BALMER STREET BLDG #570
Practice Address - Street 2:HILL AFB, 75TH MDG/SGD
Practice Address - City:HILL AFB
Practice Address - State:UT
Practice Address - Zip Code:84056
Practice Address - Country:US
Practice Address - Phone:801-777-7011
Practice Address - Fax:801-777-0590
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
WI1022141223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program