Hettinger Family Dental, P.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

HETTINGER FAMILY DENTAL, P.C.

Practice address

204 Highway 12 E
Hettinger, ND 58639-9687

Phone

(701) 567-4302

NPI assigned

Nov 28, 2022

Last updated

Jan 15, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brody W Peterson, DDSNPI 1588313134

Title

President/Owner

Phone

(605) 639-0448

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Tax ID family

Hettinger Family Dental PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Hettinger Family Dental, P.C.

  dba Dickinson Dental Center

  • Dentist
  • Dickinson, ND
  • NPI 1902617103
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Hettinger Family Dental, P.C.

  dba Dickinson Dental Center

  • Dentist
  • Dickinson, ND
  • NPI 1902617103
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brody William Peterson

  • Dentist
  • Dickinson, ND
  • NPI 1588313134
  NPD (past) Authorized official
• Mark W Nelson, D.D.S.

  • General Practice Dentistry
  • Hettinger, ND
  • NPI 1124043583
  NPD (past)

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1851001168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 469",
            "city": "HETTINGER",
            "state": "ND",
            "postal_code": "586390469",
            "telephone_number": "701-567-4032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 HIGHWAY 12 E",
            "city": "HETTINGER",
            "state": "ND",
            "postal_code": "586399687",
            "telephone_number": "701-567-4302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 1st St W Ste 215",
            "address_purpose": "LOCATION",
            "city": "Dickinson",
            "state": "ND",
            "postal_code": "586015106",
            "country_code": "US",
            "telephone_number": "701-483-6999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HETTINGER FAMILY DENTAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-28",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "BRODY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "605-639-0448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PROVIDER IDENTIFIER",
            "identifier": "1588313134",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hfdental@ndsupernet.com",
            "affiliation": "N",
            "endpointDescription": "office email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "204 Highway 12 E",
            "city": "Hettinger",
            "state": "ND",
            "country_code": "US",
            "postal_code": "586399687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Susan K Hallen
• Suzan Jean Hanson, DC
• Lynly J Hebert, MS OTR L
• Jacquelyn Ann Hedstrom, DNP APRN PMHNP-BC
• Helen Andrea Henley
• Kent R Hoerauf, MD
• Rebecca Howe, APRN, FNP-C
• Courtney Hulm
• Thomas E Jacobsen, MD
• Kali Jacobson

• Dental Clinic/Center in Hettinger, ND
• Providers in Hettinger, ND by specialty
• Dental Clinic/Center in North Dakota

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