Peter Neilson Jeppsen, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN.00203187 Issued in CO

Practice address

2500 30TH St Ste 204
Boulder, CO 80301-1258

Phone

(918) 207-5526

NPI assigned

Dec 7, 2009

Sex

Male

Sole proprietor

No

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)

Enrolled

State licenses

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1972831709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2814 RIDGE VIEW CIRCLE",
            "address_2": "APT D",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "80516",
            "telephone_number": "918-207-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 30TH ST STE 204",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011258",
            "telephone_number": "918-207-5526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3860 Highway 412 E",
            "address_2": "Suite F",
            "address_purpose": "LOCATION",
            "city": "Siloam Springs",
            "state": "AR",
            "postal_code": "727618510",
            "country_code": "US",
            "telephone_number": "479-524-9379 x24",
            "fax_number": "479-524-0976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEPPSEN",
        "first_name": "PETER",
        "middle_name": "NEILSON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3717",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00203187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nan Jenner-Bryant, LPC
• Shalini Bhatia Jennings, LCSW
• Kelly Elizabeth Clark Jensen, M.D.
• Lori Lynn Jensen, MD
• Renee Jeong, PHARM.D.
• Jeremiah Kaplan MD PLLC
• Jesse Friedman, DMD, PC
• Diane Jessee
• Jessica McCrea, LLC
• Linnea Jewett, MA, LPC

• General Practice Dentistry in Boulder, CO
• Providers in Boulder, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.