NPIMap

Organization Active NPI

Peterson Dental Group, PC

Doing business as Gentle Dental South Maryland

  • Dentist
  • Las Vegas, NV
National Provider Identifier
1336356682
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PETERSON DENTAL GROUP, PC
Doing business as
Gentle Dental South Maryland
Practice address
8880 S Maryland Pkwy Ste 100
Las Vegas, NV 89123-6718
Phone
(702) 270-8790
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Authorized official

Name
Dr. Bradley R Peterson, DDS
Title
PC Owner
Phone
(360) 869-7645

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

8880 S Maryland Pkwy Ste 100
Las Vegas, NV 89123-6718

Mailing address

PO Box 872710
Vancouver, WA 98687-2710
Phone (360) 869-7645

Other names 1

  • Gentle Dental South Maryland Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gentle Dental Charleston13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8880 S Maryland Pkwy
Ste 100
Las Vegas, NV 89123
Phone (702) 270-8790

1725 E Warm Springs Rd
Ste 2
Las Vegas, NV 89119
Phone (702) 270-8790

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755820800000",
    "number": "1336356682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 872710",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986872710",
            "telephone_number": "360-869-7645",
            "fax_number": "877-725-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8880 S MARYLAND PKWY STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891236718",
            "telephone_number": "702-270-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON DENTAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PC OWNER",
        "authorized_official_telephone_number": "360-869-7645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentle Dental South Maryland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.