Douglas Don Peterson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D15386 Issued in MN

Practice address

2411 10TH Ave N
Lake Worth, FL 33461-3128

Phone

(561) 966-9557

Fax

(561) 966-5886

NPI assigned

Apr 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1952520710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 10TH AVE N",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334613128",
            "telephone_number": "561-966-9557",
            "fax_number": "561-966-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 10TH AVE N",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334613128",
            "telephone_number": "561-966-9557",
            "fax_number": "561-966-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DOUGLAS",
        "middle_name": "DON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "9930",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D15386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Perry-Folgueira
• Daria Perry, LMFT
• Marie J Perry, OT
• Kurt Kumar Persaud
• Peter J Lowe, M.D. P.a.
• Monose Petit-Frere
• Bianca Rose Petrocelli, OTR/L
• Julianna Marie Petrone, LCSW
• Sonja Pezzelle, MA71806
• Pharmacy Practice Associates, PA

• General Practice Dentistry in Lake Worth, FL
• Providers in Lake Worth, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.