Jacob Dean Peterson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1679 Issued in WY

Practice address

5000 Blackmore Rd
Casper, WY 82609-3345

Phone

(307) 233-6000

Fax

(307) 233-6019

NPI assigned

Mar 5, 2024

Last updated

Jan 29, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tatiana K Steele

  dba Gentle Touch Dental

  • General Practice Dentistry
  • Cheyenne, WY
  • NPI 1578102067
  NPD
• Community Health Center of Central Wyoming, Inc.

  • Federally Qualified Health Center (FQHC)
  • Casper, WY
  • NPI 1447480561
  NPD (past)

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

{
    "created_epoch": "1709596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1407613425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 BLACKMORE RD",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826093345",
            "telephone_number": "307-233-6000",
            "fax_number": "307-233-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 BLACKMORE RD",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826093345",
            "telephone_number": "307-233-6000",
            "fax_number": "307-233-6019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JACOB",
        "middle_name": "DEAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-05",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WY",
            "license": "1679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Personalized Support Services
• Jacqueline Ann Peters, M.D.
• Paul Leon Peters, MD
• Roberta A Peters, RN
• Mary Petersen
• Jessica Ann Peterson, CPNP-PC
• Robert Lee Peterson, PSY.D.
• Archie Maurice Pettry III, M.S.
• Ashleigh Carolyn Petty
• Pharmaceutical Compounding Specialists of Wyoming

• Dentist in Casper, WY
• Providers in Casper, WY by specialty
• Dentist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.