Nathaniel J Peterson DMD PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

NATHANIEL J PETERSON DMD PLLC

Practice address

1403 Troy Rd Ste B
Edwardsville, IL 62025-2590

Phone

(630) 618-9211

NPI assigned

Sep 18, 2026

Organization subpart

No

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

Authorized official

Name

Dr. Nathaniel J Peterson, DMD

Title

Dentist

Phone

(630) 618-9211

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1789689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789689600000",
    "number": "1295647972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 MADISON AVE",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252323",
            "telephone_number": "630-618-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 TROY RD STE B",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252590",
            "telephone_number": "630-618-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATHANIEL J PETERSON DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-18",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "630-618-9211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Murphy
• Daniel Murphy
• Rylie M Murray, ATC
• Hailee Rae Myers
• Nueki Naate, MD
• Suman Dilip Navalgund, O.D.
• Krista Nicole Nelson, D.P.M.
• Mary Beth Nelson
• Angelle N Newell
• Next Step Foot & Ankle Centers

• General Practice Dentistry in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.