Active NPI
Aden Peterson, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Fort Collins, CO
National Provider Identifier
1013575430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DEN.00205199
- Practice address
- 1015 S Taft Hill Rd Ste K
Fort Collins, CO 80521-4240 - Phone
- (970) 980-2145
- NPI assigned
- May 31, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DEN.00205199 | CO | Primary |
Addresses
Primary practice location
1015 S Taft Hill Rd Ste K
Fort Collins, CO 80521-4240
Mailing address
927 Emery St
Longmont, CO 80501-4508
Phone (802) 922-6547
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00205199 | CO | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PDG, P.a. | Past | Accepting new patients | |
| St. Croix Valley Dental, PLLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dental Clinic/Center
- Rosemount, MN
- NPI 1538598057
-
- Point of Service
- Rosemount, MN
- NPI 1619144540
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719187200000",
"number": "1013575430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "927 EMERY ST",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805014508",
"telephone_number": "802-922-6547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 S TAFT HILL RD STE K",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805214240",
"telephone_number": "970-980-2145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "ADEN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-31",
"last_updated": "2024-06-24",
"certification_date": "2024-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CO",
"license": "DEN.00205199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.