Active NPI
Peyton Halverson Granger, DDS
- General Practice Dentistry
- Devils Lake, ND
National Provider Identifier
1154217578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2558
- Practice address
- 206 5TH Ave SE
Devils Lake, ND 58301-3602 - Phone
- (701) 662-8191
- NPI assigned
- Jun 13, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2558 | ND | Primary |
Addresses
Primary practice location
206 5TH Ave SE
Devils Lake, ND 58301-3602
Mailing address
206 5TH Ave SE
Devils Lake, ND 58301-3602
Phone (701) 662-8191
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Aug 20, 2025 through Aug 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS. Herman & Mack PC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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": "1749772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749772800000",
"number": "1154217578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 5TH AVE SE",
"city": "DEVILS LAKE",
"state": "ND",
"postal_code": "583013602",
"telephone_number": "701-662-8191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 5TH AVE SE",
"city": "DEVILS LAKE",
"state": "ND",
"postal_code": "583013602",
"telephone_number": "701-662-8191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALVERSON GRANGER",
"first_name": "PEYTON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-13",
"last_updated": "2025-06-13",
"certification_date": "2025-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ND",
"license": "2558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Devils Lake, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.