Larry J Peterson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2842 Issued in DC

Practice address

1234 19TH St NW
Suite 200
Washington, DC 20036-2407

Phone

(202) 785-0555

Fax

(202) 785-5566

NPI assigned

Aug 21, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518072172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 19TH ST NW",
            "address_2": "SUITE 200",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200362407",
            "telephone_number": "202-785-0555",
            "fax_number": "202-785-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 19TH ST NW",
            "address_2": "SUITE 200",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200362407",
            "telephone_number": "202-785-0555",
            "fax_number": "202-785-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LARRY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "2842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DISTRICT OF COLUMBIA",
            "identifier": "2842",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hattie Anna Peterson, MSW, LICSW
• Jamie Peterson, LPC, ATR-BC
• Karen Peterson
• Katrina Peterson
• Kia Marie Peterson
• Lauren Peterson, MD
• M. Candi Peterson, MSW
• Naomi Glenn Peterson, DNP, ACNPC-AG
• Patricia Ann Peterson
• Paul Carlton Peterson

• Dentist in Washington, DC
• Providers in Washington, DC by specialty
• Dentist in District of Columbia

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.