Individual provider Active NPI

Stephen Benjamin Peterman, D.D.S.

  • Prosthodontics
  • Brentwood, TN
National Provider Identifier
1104131572
Registry record updated Feb 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
12700 Issued in TN
Practice address
1177 Old Hickory Blvd Ste 102
Brentwood, TN 37027-4242
Phone
(615) 690-5400
NPI assigned
Aug 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 12700 TN Primary
Dentist 122300000X 6902 NE
Dentist 122300000X 12700 TN

Addresses

Primary practice location

1177 Old Hickory Blvd Ste 102
Brentwood, TN 37027-4242

Mailing address

1177 Old Hickory Blvd Ste 102
Brentwood, TN 37027-4242
Phone (615) 690-5400

Other practice location 1

2940 Stanley Rd Ste 2375
Fort Sam Houston, TX 78234-2740
Phone (210) 295-4156

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

LicenseStateTypeSpecialty
6902NEMDCardiovascular Disease Physician
12700TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Sleep Apnea Solutions, PLLC PastSince Aug 11, 2024 Accepting new patients
Middle Tennessee Prosthodontics, LLC Prosthodontics PastSince Apr 6, 2025 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.

NPI Registry JSON

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771632000000",
    "number": "1104131572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 OLD HICKORY BLVD STE 102",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274242",
            "telephone_number": "615-690-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 OLD HICKORY BLVD STE 102",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274242",
            "telephone_number": "615-690-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2940 Stanley Rd Ste 2375",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782342740",
            "country_code": "US",
            "telephone_number": "210-295-4156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERMAN",
        "first_name": "STEPHEN",
        "middle_name": "BENJAMIN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-10",
        "last_updated": "2026-02-21",
        "certification_date": "2026-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "TN",
            "license": "12700",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "6902",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "12700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2026; 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.