Kent T Peterson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6852 Issued in KS

Practice address

2210 Yale Rd
Lawrence, KS 66049-2647

Phone

(785) 842-0705

Fax

(785) 865-2324

NPI assigned

Mar 17, 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

Enrolled in KS

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

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1679542831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 YALE RD",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660492647",
            "telephone_number": "785-842-0705",
            "fax_number": "785-865-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 YALE RD",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660492647",
            "telephone_number": "785-842-0705",
            "fax_number": "785-865-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KENT",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "6852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "116690",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Personalized Family Dental Care, P.a.
• Personalized Solutions LLC
• Meaghan Peters, RBT
• Cody Peterson, DPT
• Jessica Lynn Peterson, D.C.
• Peterson, Krische, Van Horn, DDS, LLC
• Pete Peterson, PHD
• Zineta Petrovic, LMSW
• Abigail Dawn Petrulis, PHARMD
• Grace Petz

• General Practice Dentistry in Lawrence, KS
• Providers in Lawrence, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.