Active NPI
Guy E Peterson, DDS
- Dentist
- Bulverde, TX
National Provider Identifier
1821246695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 20998
- Practice address
- 2395 Bulverde Rd
Suite 103
Bulverde, TX 78163-4571 - Phone
- (830) 980-2869
- Fax
- (830) 438-3363
- NPI assigned
- Sep 4, 2008
- Last updated
- Nov 6, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 20998 | TX | Primary |
Addresses
Primary practice location
2395 Bulverde Rd
Suite 103
Bulverde, TX 78163-4571
Mailing address
2395 Bulverde Rd
Suite 103
Bulverde, TX 78163-4571
Phone (830) 980-2869
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Previously, effective Oct 12, 2016 through Oct 12, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20998 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Original Bulverde Dental Office, PA | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257465600000",
"number": "1821246695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2395 BULVERDE RD",
"address_2": "SUITE 103",
"city": "BULVERDE",
"state": "TX",
"postal_code": "781634571",
"telephone_number": "830-980-2869",
"fax_number": "830-438-3363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2395 BULVERDE RD",
"address_2": "SUITE 103",
"city": "BULVERDE",
"state": "TX",
"postal_code": "781634571",
"telephone_number": "830-980-2869",
"fax_number": "830-438-3363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "GUY",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-04",
"last_updated": "2009-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "20998",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bulverde, TX
- Renee Patlan, AGACNP-BC
- Jacalyn B Patton, M.S.P.A.
- Artrevisa Payton, LCSW
- Kristi Ellen Perkins, M.D.
- Amber Vigue Peterson, MPAS PAC
- Debra Colleen Phelps, LMT
- McKenna Leeann Powell, M.S., CCC-SLP
- Kellie Pryor, LCMHC
- R Scott Harris (Hillside Chiropractic and Wellness)
- Heather Knox Redding, MA, LPC-ASSOCIATE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; 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.