Great Smile Dental of Bend LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GREAT SMILE DENTAL OF BEND LLC

Doing business as

Aesthetic Dentistry of Bend

Practice address

124 NW Hawthorne Ave
Bend, OR 97703-2918

Phone

(541) 389-1301

NPI assigned

Sep 15, 2026

Organization subpart

No

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

Authorized official

Name

Dr. Peter B Amundson, DMD

Title

Dentist/Owner

Phone

(303) 521-2916

Specialties & licenses 1

Addresses

Other names 1

• Aesthetic Dentistry of Bend Doing business as

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

{
    "created_epoch": "1789430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789430400000",
    "number": "1285545608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 NW HAWTHORNE AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032918",
            "telephone_number": "541-389-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 NW HAWTHORNE AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032918",
            "telephone_number": "541-389-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT SMILE DENTAL OF BEND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-15",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A",
        "authorized_official_last_name": "AMUNDSON",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "303-521-2916",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aesthetic Dentistry of Bend",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Bend, OR
• Providers in Bend, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.