Noah J Peters, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2249 Issued in MT

Practice address

715 W Central Ave
Missoula, MT 59801-6808

Phone

(406) 728-2840

Fax

(406) 728-3083

NPI assigned

Jul 2, 2007

Last updated

Jan 13, 2011By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 31, 2016 through Mar 31, 2028

Medicare enrollment (NPD)

Not enrolled

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.

• Olsen Dental PC

  dba Olsen and Peters Dental Group

  • Dentist
  • Missoula, MT
  • NPI 1578337705
  NPD (past)

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294876800000",
    "number": "1710184775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 W CENTRAL AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016808",
            "telephone_number": "406-728-2840",
            "fax_number": "406-728-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 W CENTRAL AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016808",
            "telephone_number": "406-728-2840",
            "fax_number": "406-728-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "NOAH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2011-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "2249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIP",
            "identifier": "5512754",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "41244",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0113305",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jo Scandrett Persons, RDH
• Katlyn Perugini, MA
• Walter Howard Peschel, M.D.
• Christina Peters, DPT
• Jeffrey Peters, PTA
• Rebecca M Peters, LMT
• Kimberley Michelle Petersen, NP
• Janine B Peterson-Hale, MD
• Anna Louise Peterson, ED.D, LCPC
• Brad Peterson, M.D.

• General Practice Dentistry in Missoula, MT
• Providers in Missoula, MT by specialty
• General Practice Dentistry in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.