NPIMap

Organization Active NPI

Peterson Dental Group, PC

  • Dentist
  • North Las Vegas, NV
National Provider Identifier
1093533762
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
Practice address
7920 N Decatur Blvd
Suite 106
North Las Vegas, NV 89084
Phone
(702) 673-5772
Fax
(702) 921-9931
NPI assigned
Oct 1, 2024
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
Phone
(360) 869-7645

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

7920 N Decatur Blvd
Suite 106
North Las Vegas, NV 89084

Mailing address

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

Other names 1

  • Gentle Dental North Las Vegas 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

7920 N Decatur Blvd
Ste 106
Las Vegas, NV 89131
Phone (702) 673-5772

7920 N Decatur Blvd
Ste 101
Las Vegas, NV 89131

NPI Registry JSON

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755820800000",
    "number": "1093533762",
    "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": "7920 N DECATUR BLVD",
            "address_2": "SUITE 106",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89084",
            "telephone_number": "702-673-5772",
            "fax_number": "702-921-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON DENTAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-01",
        "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",
        "authorized_official_telephone_number": "360-869-7645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentle Dental North Las Vegas",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gentle Dental North Las Vegas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Las Vegas, 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.