Helen Katie Peterson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010757A Issued in IN

Practice address

2802 Lafayette Rd Ste 33
Indianapolis, IN 46222-2112

Phone

(317) 925-2810

NPI assigned

Nov 10, 2006

Last updated

Oct 29, 2024By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

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.

• Indy East Smiles Youth Dentistry LLC

  dba Prime Smile East

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1013952696
  NPD (past) Authorized official
• Indy West Smiles Youth Dentistry, LLC

  dba Prime Smile West

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1134164445
  NPD (past) Authorized official

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1760553937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 E WASHINGTON ST STE 101",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462196616",
            "telephone_number": "317-322-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 LAFAYETTE RD STE 33",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462222112",
            "telephone_number": "317-925-2810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6005 E Washington St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462196616",
            "country_code": "US",
            "telephone_number": "317-322-1840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "HELEN",
        "middle_name": "KATIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010757A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200532910",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christian Peterson
• Donna Peterson, PTA
• Ellen Louise Peterson, MD
• Emily Peterson
• Erin Kay Peterson, MOT, OTR
• Jan E Peterson II, MD
• Joanna Sue Peterson, MGW, LCSW
• Laryn A Peterson, M.D.
• Madeline Rae Peterson, NP
• Matthew Peterson

• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.