Scott T Peterson, D.M.D. M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D009577 Issued in AZ

Practice address

5235 W Baseline Rd
#187
Laveen, AZ 85339-3122

Phone

(602) 605-8811

NPI assigned

Jan 10, 2017

Last updated

Jan 10, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Scott Peterson DMD Ms PLLC

  dba Peterson Family Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Queen Creek, AZ
  • NPI 1558887893
  Authorized official Same address or phone
• Scott T Peterson

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Gilbert, AZ
  • NPI 1912452558
  NPD (past) Authorized official

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1619413093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4216 S MARIPOSA DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852975224",
            "telephone_number": "480-440-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5235 W BASELINE RD",
            "address_2": "#187",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853393122",
            "telephone_number": "602-605-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SCOTT",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.M.D. M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-10",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "D009577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peaceful Hogar LLC
• Penali Manor LLC
• Lauryn Perrotti
• Jeanette Perry-Brunson
• Lisa Ann Peterson, LISAC
• Fabiana Pettroza
• Nicole Peyton, D.C.
• Pha Residential LLC
• Philia Homecare LLC
• Phoenix Happy Living LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Laveen, AZ
• Providers in Laveen, AZ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.