Individual provider Active NPI

Gregory Scott Peterson, D.M.D.

  • General Practice Dentistry
  • Pittsburgh, PA
National Provider Identifier
1265525943
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS-025423-L Issued in PA
Practice address
1725 Washington Road
Suite #505
Pittsburgh, PA 15241-2131
Phone
(412) 833-3944
Fax
(412) 833-4347
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS-025423-L PA Primary

Addresses

Primary practice location

1725 Washington Road
Suite #505
Pittsburgh, PA 15241-2131

Mailing address

1725 Washington Road
Suite #505
Pittsburgh, PA 15241-2131
Phone (412) 833-3944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20160601000535 PA Order and Referring Only - DentistPractitioner - Dentist 5799075941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS-025423-LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
South Pittsburgh Dental Studio PLLC General Practice Past Accepting new patients
Gregory S Peterson DMD & Associates Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265525943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 WASHINGTON ROAD",
            "address_2": "SUITE #505",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152412131",
            "telephone_number": "412-833-3944",
            "fax_number": "412-833-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 WASHINGTON ROAD",
            "address_2": "SUITE #505",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152412131",
            "telephone_number": "412-833-3944",
            "fax_number": "412-833-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-025423-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.