Shon J Peterson, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

8741 Issued in CO

Practice address

11265 Decatur St Ste 400
Westminster, CO 80234-4793

Phone

(303) 452-4656

Fax

(303) 254-6994

NPI assigned

Sep 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Shon J Peterson, DMD, Ms

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Westminster, CO
  • NPI 1699048439
  NPD (past) Authorized official

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1831292929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11265 DECATUR ST STE 400",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802344793",
            "telephone_number": "303-452-4656",
            "fax_number": "303-254-6994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11265 DECATUR ST STE 400",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802344793",
            "telephone_number": "303-452-4656",
            "fax_number": "303-254-6994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "8741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699048439",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jon Tor Peterson, PHARMD
• Jonathan B Peterson, MD
• Juniper Peterson
• Katherine Peterson
• Robert Peterson, MA, NCC, LPC
• Theresa Peterson
• Justin Petracek, DDS
• Madison Ann Petrowski
• Suzanne Pfefferle, MA, LPC
• Catherine Marie Pfeiffer

• Orthodontics and Dentofacial Orthopedics Dentistry in Westminster, CO
• Providers in Westminster, CO by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.