Bradley Redge Peterson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5115 Issued in NV

Practice address

61 N Willow St
Suite 1
Mesquite, NV 89027-4785

Phone

(702) 346-2882

NPI assigned

Dec 12, 2006

Last updated

Jul 8, 2007By 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

Medicare fee-for-service enrollment

Enrolled in NV

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

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.

• David O Marchant DDS, Inc

  dba Mesquite Dental

  • General Practice Dentistry
  • Mesquite, NV
  • NPI 1205171162
  NPD (past)
• Larry B Morris, D.M.D., P.C.

  dba Mesquite Dental

  • Dentist
  • Mesquite, NV
  • NPI 1598925760
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811058365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "983 DIAMOND CIR",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890272932",
            "telephone_number": "702-345-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 N WILLOW ST",
            "address_2": "SUITE 1",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890274785",
            "telephone_number": "702-346-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BRADLEY",
        "middle_name": "REDGE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "5115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirsten Pearson
• Alice A Perkins
• Jennifer N Perkins, ED.S.
• Roy Wayne Perkins, RN
• April Christine Peterson, APRN, FNP-BC
• Rachael Phillips, BS
• Sarah Phillips
• Pinnacle Absolute Care (Mesquite Pharmacy And Medical Supplies)
• Dedra Lee Plummer
• Chaston Rae Pola, DPT

• Dentist in Mesquite, NV
• Providers in Mesquite, NV by specialty
• Dentist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.