Taylor Cole Peterson, DDS, MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

23613 Issued in MT

Practice address

614 S Ferguson Ave Ste 2
Bozeman, MT 59718-6413

Phone

(406) 586-3040

NPI assigned

Jul 30, 2018

Last updated

Aug 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1811475239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 N LOGAN ST APT 310",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802031174",
            "telephone_number": "406-868-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 S FERGUSON AVE STE 2",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186413",
            "telephone_number": "406-586-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "TAYLOR",
        "middle_name": "COLE",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-30",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00203648",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MT",
            "license": "23613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liese Pessl, NPF
• William J. Peters, MD
• Amanda Peterson
• Carl Peterson, PHARMD
• Kezia Peterson, MOTR/L
• Loreen L Pettit, MD
• Melissa Pew, P.A.
• Emily Poole Pharr, M.D.
• Philip J Owsley O D & Assoc PC
• Bradley Phillips, DC

• Periodontics in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Periodontics in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.