Gary S Peterson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4638 Issued in AZ

Practice address

123 S Stone Ave
Tucson, AZ 85701-1914

Phone

(520) 798-3384

Fax

(520) 791-9311

NPI assigned

Feb 6, 2007

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

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Abc Dental Center, PC

  • Dentist
  • Tucson, AZ
  • NPI 1811170483
  NPD (past)
• Perfect Teeth / Abc P.C.

  • Dentist
  • Tucson, AZ
  • NPI 1225365703
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518006147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7241 E ROCKY RIDGE DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857506034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S STONE AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857011914",
            "telephone_number": "520-798-3384",
            "fax_number": "520-791-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "GARY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "4638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles John Peterson, MD
• Christopher Luke Peterson, D.O.
• Douglas Peterson, MD
• Erin Peterson, PT
• Gary Jack Peterson, LAC-23090
• Holly Peterson, PHARMD
• Jacquelyn Peterson, RN, BSN
• Jeffrey Hal Peterson, D.C.
• John Peterson, PHARMD
• Julie Marie Peterson, L.AC. DIPL.AC.

• General Practice Dentistry in Tucson, AZ
• Providers in Tucson, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.