NPIMap

Organization Active NPI

Peterson Family Dental PLLC

  • Dentist
  • Dover, NH
National Provider Identifier
1962746545
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1725 Issued in NH
Legal business name
PETERSON FAMILY DENTAL PLLC
Practice address
240 Locust St
Dover, NH 03820-4034
Phone
(603) 742-6546
Fax
(603) 742-7043
NPI assigned
Nov 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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

Authorized official

Name
Stephan L Peterson, DDSNPI 1225197841
Title
Dentist
Phone
(603) 742-6546

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 1725 NH Primary

Addresses

Primary practice location

240 Locust St
Dover, NH 03820-4034

Mailing address

240 Locust St
Dover, NH 03820-4034
Phone (603) 742-6546

National Provider Directory

National Provider Directory

Locations

240 Locust St
Dover, NH 03820
Phone (603) 742-6546

Practitioners & affiliated clinicians

Practitioners 3

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": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482969600000",
    "number": "1962746545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 LOCUST ST",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038204034",
            "telephone_number": "603-742-6546",
            "fax_number": "603-742-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 LOCUST ST",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038204034",
            "telephone_number": "603-742-6546",
            "fax_number": "603-742-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2016-12-29",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "603-742-6546",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NH",
            "license": "1725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.