Vacharee Sriswad Peterson

Primary specialty

DentistTaxonomy code 122300000X

License

D9309 Issued in MN

Practice address

828 Hawthorne St E
Saint Paul, MN 55106-3252

Phone

(651) 774-2959

NPI assigned

Jan 26, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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 MN

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

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.

• Peterson & Peterson DDS PA

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1013988765
  NPD (past) Authorized official

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1184694408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1184 ORANGE AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551062075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 HAWTHORNE ST E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551063252",
            "telephone_number": "651-774-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "VACHAREE",
        "middle_name": "SRISWAD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D9309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Jean Peterson
• Samantha Lynn Peterson
• Sophia G Peterson, PT
• Steven R Peterson, PT
• Tanner Peterson
• Melissa Joy Petrangelo, RN
• Chase Eugene Petron, DC
• Kailee Anne Winkle Petrosky
• Teresa Petruccelli
• Laura K Petry, CPNP

• Dentist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.