NPIMap

Organization Active NPI

Peterson Dental Group, PC

Doing business as Gentle Dental Sparks

  • Dentist
  • Sparks, NV
National Provider Identifier
1023483534
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PETERSON DENTAL GROUP, PC
Doing business as
Gentle Dental Sparks
Practice address
2399 Wingfield Hills Rd
Ste 130
Sparks, NV 89436-7207
Phone
(775) 473-6031
Fax
(775) 354-1507
NPI assigned
Dec 9, 2015
Last updated
Aug 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Bradley R Peterson, DDS
Title
PC Owner/President
Phone
(360) 869-7645

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

2399 Wingfield Hills Rd
Ste 130
Sparks, NV 89436-7207

Mailing address

PO Box 872710
Vancouver, WA 98687-2710
Phone (360) 869-7645

Other names 1

  • Gentle Dental Sparks Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gentle Dental Charleston13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2399 Wingfield Hills Rd
Ste 130
Sparks, NV 89436
Phone (775) 473-6031

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755820800000",
    "number": "1023483534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 872710",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986872710",
            "telephone_number": "360-869-7645",
            "fax_number": "877-725-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2399 WINGFIELD HILLS RD",
            "address_2": "STE 130",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894367207",
            "telephone_number": "775-473-6031",
            "fax_number": "775-354-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON DENTAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-09",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PC OWNER/PRESIDENT",
        "authorized_official_telephone_number": "360-869-7645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentle Dental Sparks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.