Active NPI
John Benner Peterman III, DMD
- Dentist
- Conestoga, PA
National Provider Identifier
1295140242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9047351-9921
- Practice address
- 5 Apache Cir
Conestoga, PA 17516-9507 - Phone
- (717) 669-8340
- NPI assigned
- Jun 29, 2014
- Last updated
- Jun 29, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 9047351-9921 | UT | Primary |
Addresses
Primary practice location
5 Apache Cir
Conestoga, PA 17516-9507
Mailing address
5 Apache Cir
Conestoga, PA 17516-9507
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9047351-9921 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404000000000",
"number": "1295140242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 APACHE CIR",
"city": "CONESTOGA",
"state": "PA",
"postal_code": "175169507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 APACHE CIR",
"city": "CONESTOGA",
"state": "PA",
"postal_code": "175169507",
"telephone_number": "717-669-8340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERMAN",
"first_name": "JOHN",
"middle_name": "BENNER",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-29",
"last_updated": "2014-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "9047351-9921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conestoga, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.