Peterson Orthodontics LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

PETERSON ORTHODONTICS LLC

Practice address

624 N 129TH St Ste 100
Omaha, NE 68154-6110

Phone

(402) 330-9564

Fax

(402) 330-9564

NPI assigned

May 14, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Landon R Peterson, DDS, MSNPI 1427534106

Title

Owner

Phone

(402) 330-9564

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Landon Peterson, DDS

  • Dentist
  • Omaha, NE
  • NPI 1427534106
  NPD Authorized official
• Barbara J Ries, DDS, MS, PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Omaha, NE
  • NPI 1295826139
  NPD (past)

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

{
    "created_epoch": "1747180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1831980473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 N 129TH ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681546110",
            "telephone_number": "402-330-9564",
            "fax_number": "402-330-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 N 129TH ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681546110",
            "telephone_number": "402-330-9564",
            "fax_number": "402-330-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON ORTHODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-14",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "LANDON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-330-9564",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10029018000",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Petersen, ED.S.
• Vera Lynn Petersen, MA, PLMHP
• Whitney J Petersen, APRN-NP
• Tara Jade Peterslie, RBT
• Amanda Louise Petersmith, APRN-NP, MSN,CPNP-AC
• Peterson Physical Therapy LLC
• Peterson Physical Therapy, PC
• Alvernia M Peterson
• Angela Peterson
• Anna Peterson

• Orthodontics and Dentofacial Orthopedics Dentistry in Omaha, NE
• Providers in Omaha, NE by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; 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.