Peterson Dental Care LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019029045 Issued in IL

Legal business name

PETERSON DENTAL CARE LLC

Practice address

2501 W Iles Ave Ste a
Springfield, IL 62704-6482

Phone

(217) 787-4015

NPI assigned

Jun 8, 2018

Organization subpart

No

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

Authorized official

Name

James Peterson, DDSNPI 1376806224

Title

Owner

Phone

(630) 780-9964

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Peterson, DDS

  • General Practice Dentistry
  • Springfield, IL
  • NPI 1376806224
  NPD Authorized official
• Stephan Alan Kaplan, D.D.S.

  • Dentist
  • Springfield, IL
  • NPI 1841340635
  NPD (past)

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

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784764800000",
    "number": "1316430952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 W ILES AVE STE A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046482",
            "telephone_number": "217-787-4015",
            "fax_number": "217-787-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W ILES AVE STE A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046482",
            "telephone_number": "217-787-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-08",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-780-9964",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019029045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Froilan V Perucho, APN
• Mary T Peter, M.D.
• Andrea Peters, AGPCNP-C
• Felicia Peters
• Susan Elizabeth Peters, RBT
• Andrea Dawn Peterson, LCSW
• David R Peterson, M.D.
• Devin Peterson, MD
• James Peterson, DDS
• Paige A Peterson

• Dental Clinic/Center in Springfield, IL
• Providers in Springfield, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.