NPIMap

Organization Active NPI

Peterson Dental Group, PC

  • Dentist
  • Las Vegas, NV
National Provider Identifier
1952518201
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PETERSON DENTAL GROUP, PC
Practice address
5527 S Rainbow Blvd
Ste a
Las Vegas, NV 89118-1881
Phone
(702) 367-4440
Fax
(702) 365-0723
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Authorized official

Name
Dr. Bradley R Peterson, DDS
Title
PC Owner/President
Phone
(360) 869-7645

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

5527 S Rainbow Blvd
Ste a
Las Vegas, NV 89118-1881

Mailing address

PO Box 872710
Vancouver, WA 98687-2710
Phone (360) 869-7645

Other names 1

  • Gentle Dental Spanish Trail Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gentle Dental Charleston13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

5527 S Rainbow Blvd
Ste A
Las Vegas, NV 89118
Phone (702) 367-4440

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755820800000",
    "number": "1952518201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 872710",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986872710",
            "telephone_number": "360-869-7645",
            "fax_number": "877-725-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5527 S RAINBOW BLVD",
            "address_2": "STE A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181881",
            "telephone_number": "702-367-4440",
            "fax_number": "702-365-0723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON DENTAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PC OWNER/PRESIDENT",
        "authorized_official_telephone_number": "360-869-7645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentle Dental Spanish Trail",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.