Peterson Family Dental, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

08702 Issued in IA

Legal business name

PETERSON FAMILY DENTAL, PC

Practice address

932 42ND St
Des Moines, IA 50312-2626

Phone

(515) 277-3551

NPI assigned

Jul 18, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin Robert Peterson, D.D.S.

Title

Dentist

Phone

(319) 331-6351

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Thomas Zisko, D.D.S

  • General Practice Dentistry
  • Des Moines, IA
  • NPI 1851441596
  NPD (past)

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

{
    "created_epoch": "1437177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437177600000",
    "number": "1437533569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 WINTER RIDGE RD",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506134775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 42ND ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503122626",
            "telephone_number": "515-277-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON FAMILY DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-18",
        "last_updated": "2015-07-18",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "319-331-6351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IA",
            "license": "08702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA DENTAL BOARD",
            "identifier": "08702",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cody Petersen, MD
• Greta Jane Petersen, PHARMD
• Patricia Jean Petersen, LISW
• Shannon Marie Petersen, P.T.
• Stacey Rae Petersen, NURSE PRACTITIONER
• Alicia Peterson, RN
• Cynthia W Peterson, NP
• Eric M Peterson, PHARM.D.
• Evan Douglas Peterson, PA-C
• Gregory E Peterson, D.O.

• Dental Clinic/Center in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Dental Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2015; 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.