Guy E Peterson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

20998 Issued in TX

Practice address

2395 Bulverde Rd
Suite 103
Bulverde, TX 78163-4571

Phone

(830) 980-2869

Fax

(830) 438-3363

NPI assigned

Sep 4, 2008

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

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 12, 2016 through Oct 12, 2026

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 and National Provider Directory roles.

• The Original Bulverde Dental Office, PA

  • Dentist
  • Bulverde, TX
  • NPI 1265508956
  NPD (past)

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": []
}

• 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
• Heather Knox Redding, MA, LPC-ASSOCIATE

• Dentist in Bulverde, TX
• Providers in Bulverde, TX by specialty
• Dentist in Texas

• 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.

Verify at the official NPI Registry.