Steven R Peterson, DDS SC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6154-015 Issued in WI

Practice address

1700 Tainter St
Suite a
Menomonie, WI 54751-8200

Phone

(715) 235-4291

Fax

(715) 235-4292

NPI assigned

Apr 23, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1043485865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 TAINTER ST",
            "address_2": "SUITE A",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547518200",
            "telephone_number": "715-235-4291",
            "fax_number": "715-235-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 TAINTER ST",
            "address_2": "SUITE A",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547518200",
            "telephone_number": "715-235-4291",
            "fax_number": "715-235-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "STEVEN",
        "middle_name": "R",
        "credential": "DDS SC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6154-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn T Peissig, NP
• Victoria Rose Perron
• James Scott Persing, MD
• Alicia Peterson, MSW, APSW
• Shane C Peterson, D.C.
• Michael R. Phillips, M.D.
• Sylvia E Piekarz, MS, CSW, LPC
• Stacy Ann Plumer, MSW LCSW
• Positive Alternatives, Inc.
• William Rogers Powell, DDS

• General Practice Dentistry in Menomonie, WI
• Providers in Menomonie, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.