Landon Peterson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

7474 Issued in NE

Practice address

624 N 129TH St Ste 100
Omaha, NE 68154-6110

Phone

(402) 330-9564

NPI assigned

Jul 16, 2018

Sex

Male

Sole proprietor

Yes

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

State licenses

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 and National Provider Directory roles.

• Peterson Orthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Omaha, NE
  • NPI 1831980473
  NPD Authorized official
• Unmc College of Dentistry

  • Dentist
  • Lincoln, NE
  • NPI 1649646746
  NPD (past)

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1427534106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 N 129TH ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681546110",
            "telephone_number": "023-330-9564",
            "fax_number": "402-330-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 N 129TH ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681546110",
            "telephone_number": "402-330-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LANDON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-16",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "7474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Anne Peterson, PT
• Kathleen Sue Peterson
• Kathrine L Peterson
• Kelli A Peterson, M.D.
• Kevin Richard Peterson, PHARMD RPH
• Larry Gerard Peterson
• Maggie Peterson
• Marcie H Peterson, MD
• Maria Peterson
• Matthew Warren Peterson, FNP

• Dentist in Omaha, NE
• Providers in Omaha, NE by specialty
• Dentist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.