Jonathan Ryan Peterson, D.M.D, M.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D7899 Issued in AZ

Practice address

800 W Chandler Blvd Ste 1
Chandler, AZ 85225-2508

Phone

(480) 899-6407

Fax

(480) 899-2644

NPI assigned

Aug 30, 2009

Last updated

Jan 17, 2013By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chandler Implants & Periodontics, LLC

  • Dental Clinic/Center
  • Chandler, AZ
  • NPI 1699013201
  NPD (past) Authorized official

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

{
    "created_epoch": "1251590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1093948614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W CHANDLER BLVD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852252508",
            "telephone_number": "480-899-6407",
            "fax_number": "480-899-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W CHANDLER BLVD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852252508",
            "telephone_number": "480-899-6407",
            "fax_number": "480-899-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JONATHAN",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D, M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-30",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D7899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aseel Peters, DMD
• Mary M Peters, D.P.M.
• Jennifer Ann Peterson-Kostalek, BHT
• Amber Peterson
• Jenna Lynn Peterson, LMT
• Kaylee M Peterson
• Tara Petges, PHARMD
• Michael Anthony Petrotto-Moreno
• Danielle Brooke Petty, RRT
• Chakorion Pfeiffer

• Dentist in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; 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.