Jessica Tara Nessmith Peterson, RDH, QOM, CERTBBM

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH009864 Issued in GA

Practice address

5450 Copper Springs LN
Cumming, GA 30040-5626

Phone

(404) 441-8917

NPI assigned

Feb 13, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1972200715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 COPPER SPRINGS LN",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300405626",
            "telephone_number": "404-441-8917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 COPPER SPRINGS LN",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300405626",
            "telephone_number": "404-441-8917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Abernathy Rd Ste 330",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303285613",
            "country_code": "US",
            "telephone_number": "404-441-8917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NESSMITH PETERSON",
        "first_name": "JESSICA",
        "middle_name": "TARA",
        "credential": "RDH, QOM, CERTBBM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "GA",
            "license": "DH009864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Hygienist in Cumming, GA
• Providers in Cumming, GA by specialty
• Dental Hygienist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.