Jessica Brereton Peterkin, DMD, MA

Primary specialty

DentistTaxonomy code 122300000X

License

D009331 Issued in AZ

Practice address

13856 W Waddell Rd Ste 102
Surprise, AZ 85379-3801

Phone

(623) 544-8353

NPI assigned

Aug 6, 2015

Last updated

Aug 22, 2015By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Ivy 2 Dental PLLC

  • Dentist
  • Tucson, AZ
  • NPI 1205408622
  NPD (past)
• Ivy 2 Dental PLLC

  • Pediatric Dentistry
  • Glendale, AZ
  • NPI 1306372503
  NPD (past)
• Ivy 2 Dental PLLC

  • Pediatric Dentistry
  • Avondale, AZ
  • NPI 1689100885
  NPD (past)
• Ivy 2 Dental PLLC

  • Dentist
  • Glendale, AZ
  • NPI 1760918965
  NPD (past)
• Ivy 2 Dental, PLLC

  dba Desert Valley Pediatric Dentistry

  • Pediatric Dentistry
  • Buckeye, AZ
  • NPI 1588922272
  NPD (past)
• Ivy 2 Dental, PLLC

  • Dentist
  • Tucson, AZ
  • NPI 1841862265
  NPD (past)
• Perfect Teeth - Waddell P.C.

  • General Practice Dentistry
  • Surprise, AZ
  • NPI 1588785729
  NPD (past)

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440201600000",
    "number": "1811373350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13856 W WADDELL RD STE 102",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853793801",
            "telephone_number": "623-544-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13856 W WADDELL RD STE 102",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853793801",
            "telephone_number": "623-544-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERKIN",
        "first_name": "JESSICA",
        "middle_name": "BRERETON",
        "name_prefix": "Dr.",
        "credential": "DMD, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D009331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perfect Teeth - Waddell P.C.
• Hollie Elaine Perlow-Schmidt, RN, IBCLC
• Perry H. Fraiman DDS PLLC
• Sasha Noel Perry, MS, OTR/L
• David N. Pessin, D.C.
• Catherine Peters
• Deanna M Peters, MA, LAC
• Monica Peters
• Shawna Peters, LPC
• Kiayra Nicole Peterson

• Dentist in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2015; 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.