Active NPI
Ian Peters, DDS
- Dentist
- Fort Liberty, NC
National Provider Identifier
1972277549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 17509
- Practice address
- 2817 Reilly St
Fort Liberty, NC 28310-7324 - Phone
- (910) 907-6974
- Fax
- (910) 907-8035
- NPI assigned
- Aug 5, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 17509 | MD | Primary |
Addresses
Primary practice location
2817 Reilly St
Fort Liberty, NC 28310-7324
Mailing address
2817 Reilly St
Fort Liberty, NC 28310-7324
Phone (910) 907-6974
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17509 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772582400000",
"number": "1972277549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2817 REILLY ST",
"city": "FORT LIBERTY",
"state": "NC",
"postal_code": "283107324",
"telephone_number": "910-907-6974",
"fax_number": "910-907-8035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2817 REILLY ST",
"city": "FORT LIBERTY",
"state": "NC",
"postal_code": "283107324",
"telephone_number": "910-907-6974",
"fax_number": "910-907-8035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "IAN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-05",
"last_updated": "2026-03-04",
"certification_date": "2026-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "17509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Liberty, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.