Active NPI
Michelle Peters, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Des Moines, IA
National Provider Identifier
1336595941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- DDS09939
- Practice address
- 7400 Fleur Dr Ste 200
Des Moines, IA 50321-3105 - Phone
- (515) 287-7773
- NPI assigned
- May 12, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DDS09939 | IA | Primary |
Addresses
Primary practice location
7400 Fleur Dr Ste 200
Des Moines, IA 50321-3105
Mailing address
7400 Fleur Dr Ste 200
Des Moines, IA 50321-3105
Phone (515) 287-7773
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 1, 2021 through Dec 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS09939 | IA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640736000000",
"number": "1336595941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7400 FLEUR DR STE 200",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503213105",
"telephone_number": "515-287-7773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7400 FLEUR DR STE 200",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503213105",
"telephone_number": "515-287-7773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "MICHELLE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-12",
"last_updated": "2021-12-29",
"certification_date": "2021-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "IA",
"license": "DDS09939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.