Tate Pearson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN-DEN-LIC-28380 Issued in MT

Practice address

1724 Nebraska Ave BLDG 1608
Fort Leonard Wood, MO 65473-8939

Phone

(573) 596-0417

NPI assigned

May 8, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1609565449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 NEBRASKA AVE BLDG 1608",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654738939",
            "telephone_number": "573-596-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 NEBRASKA AVE BLDG 1608",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654738939",
            "telephone_number": "573-596-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "TATE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-08",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "DEN-DEN-LIC-28380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josue J Paredes, PA
• Seong Jin Park
• Jennifer H Parker
• Athina Patrick, APRN-CNP
• Kenneth A Paull, LCSW
• Erica Jane Pelinski, P.A. - C
• Kenisha Shawnta Pemberton, M.D.
• Uriah Perez, ARNP
• Aren Wilhelm Peterson, DDS
• Melissa Ann Peterson, LISW, LCSW

• General Practice Dentistry in Fort Leonard Wood, MO
• Providers in Fort Leonard Wood, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.