Active NPI
Gregory Peterson, D.D.S.
- Dentist
- Brea, CA
National Provider Identifier
1437311370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 57102
- Practice address
- 503 E Imperial Hwy
Brea, CA 92821 - Phone
- (310) 266-5944
- NPI assigned
- Jul 1, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 57102 | CA | Primary |
Addresses
Primary practice location
503 E Imperial Hwy
Brea, CA 92821
Mailing address
400 Newport Center Dr
Suite 708
Newport Beach, CA 92660-7601
Phone (310) 266-5944
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Whitworth Dental Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Brea, CA
- NPI 1770591026
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527033600000",
"number": "1437311370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 NEWPORT CENTER DR",
"address_2": "SUITE 708",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926607601",
"telephone_number": "310-266-5944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 E IMPERIAL HWY",
"city": "BREA",
"state": "CA",
"postal_code": "92821",
"telephone_number": "310-266-5944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-01",
"last_updated": "2018-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "57102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brea, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.