Conor Peterson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

016.0133866 Issued in VT

Practice address

66 Morrisville PLZ Ste 2
Morrisville, VT 05661

Phone

(802) 888-7585

Fax

(802) 851-8313

NPI assigned

Feb 13, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

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

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1255870176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 GRANGER PL",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142221228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 MORRISVILLE PLZ STE 2",
            "city": "MORRISVILLE",
            "state": "VT",
            "postal_code": "05661",
            "telephone_number": "802-888-7585",
            "fax_number": "802-851-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CONOR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-13",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "016.0133866",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia J. Schricker, DC, PC
• Geneva L. Pedersen, APRN, FNP
• Elizabeth Zumwalt Perez, MD
• Personalized PT, PC
• Jennifer B Peters, M.D.
• Shaun Phillips, MS, LCMHC
• Erin Renee Pichiotino, MD
• Zoe Pickett
• Chris A. Player, LCMHC
• Ember Power

• General Practice Dentistry in Morrisville, VT
• Providers in Morrisville, VT by specialty
• General Practice Dentistry in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.