William David Peterson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901020029 Issued in MI

Practice address

2811 E Court St
Suite I
Flint, MI 48506-4054

Phone

(810) 232-2920

Fax

(810) 232-1054

NPI assigned

Jun 8, 2009

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 MI

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

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.

• Fireberg Family Dental LLC

  • Dentist
  • Flint, MI
  • NPI 1437320520
  NPD (past)

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1578799375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 VLG GREEN BLVD APT 104",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483076109",
            "telephone_number": "616-724-0412",
            "fax_number": "810-232-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 E COURT ST",
            "address_2": "SUITE I",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485064054",
            "telephone_number": "810-232-2920",
            "fax_number": "810-232-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-08",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malayia Aliza Peters
• Sarah Jean Peters, RN
• Ashley Peterson, RDH
• Dezha Peterson, MSW, LLMSW
• Sue Ann Peterson, LLBSW
• Heather E. Petherbridge, LMSW
• Tari Pethick, P.T.
• Tyra M Petoskey, LMSW, CAADC
• Rachel Kristin Petrak, MPH
• Francesca M Petrilli, DNP, ARNP-BC

• Dentist in Flint, MI
• Providers in Flint, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; 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.