DR. BYRON THAD PETERSEN (NPI# 1477566198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477566198 |
| Entity Type | Individual |
| Full Name | DR. BYRON THAD PETERSEN |
| Credential | D.D.S. |
| Practice Address |
George E Wahlen Dept of Veterans Affairs Medical Ctr 500 Foothill Drive, Dental Service (160) Salt Lake City UT 84148-0001 |
| Mailing Address |
2162 E. Creek Road Sandy UT 84093-6448 |
| Practice Telephone | 8015841206 |
| Practice Fax Number | 8015841251 |
| Mailing Telephone | 8019422631 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
135438-9923 | UT | Dental Providers |
| Street Address |
GEORGE E WAHLEN DEPT OF VETERANS AFFAIRS MEDICAL CTR 500 FOOTHILL DRIVE, DENTAL SERVICE (160) |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84148-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598211799 | Jacquelyn Rae Contant | Dietitian, Registered | 500 Foothill Dr. (120), Salt Lake City, UT 84148 | 2016-08-28 |
| 1699127811 | Taylor Alford | Pharmacist | 500 Foothills Drive, Salt Lake City, UT 84148 | 2016-07-12 |
| 1356792162 | Sarah Hummel | Genetic Counselor, MS | 500 Foothill Drive, Sarah Hummel, Va Salt Lake City, Genomic Medicine (10p4e), Salt Lake City - Salt Lake, UT 84148 | 2016-06-23 |
| 1174936140 | Elizabeth Shade Cardenas | Nurse Practitioner | 500 Foothill Drive #182h, Veterans Healthcare Administration, Salt Lake City, UT 84148 | 2014-06-08 |
| 1386904043 | David Earl Moore | Specialist | 500 Foothill Blvd (research), George E. Wahlen Va Healthcare System, Salt Lake City, UT 84148 | 2012-05-29 |
| 1790059038 | Deborah Ernstein Holley Hartzfeld | Genetic Counselor, MS | 615 Arapeen Drive #212, Salt Lake City, UT 84148 | 2012-03-05 |
| 1073823720 | Diana Lynn Robbins | Social Worker | 9140 W. Post Road, Las Vegas, NV 84148 | 2010-10-15 |
| 1659534394 | Katherine Margaret Dunn | Genetic Counselor, MS | 500 Foothill Drive (151z), Salt Lake City, UT 84148 | 2008-07-02 |
| 1730381625 | Douglas James Ball | Medical Genetics | Va Salt Lake City Health Care System 10p11, Salt Lake City, UT 84148 | 2007-06-03 |
| 1245339530 | Daniel H Priestly | Radiology | 500 Foothill Dr., Salt Lake City, UT 84148 | 2006-09-22 |
| Find all providers in zip 84148 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417575879 | Utah Family Dental Cottonwood Heights | Dentist | 7069 S Highland Dr Ste 200, Salt Lake City, UT 84121-3731 | 2020-07-10 |
| 1437772498 | Jordan Ames Whatcott | Dentist | 5888 S 900 E Ste 101, Salt Lake City, UT 84121-1644 | 2020-05-26 |
| 1043871783 | Morgan Park | Dentist | 223 S 700 E Ste 3, Salt Lake City, UT 84102-2174 | 2019-06-24 |
| 1730647330 | Salt Lake Modern Dentistry, LLP | Dentist | 1028 E 2100 S Ste 3, Salt Lake City, UT 84106-3096 | 2019-03-04 |
| 1336615244 | Jordan Heimer | Dentist | 1386 S Green St, Salt Lake City, UT 84105-2137 | 2018-10-18 |
| 1558852269 | Eric Gordon Russell | Dentist | 4465 S 900 E Ste 100, Salt Lake City, UT 84124-2695 | 2018-05-29 |
| 1851896484 | Shivani Chowdhary | Dentist | 370 E South Temple Ste 350, Salt Lake City, UT 84111 | 2018-03-26 |
| 1538687207 | Community Health Centers, Inc. | Dentist | 1078 S 300 E # 4, Salt Lake City, UT 84111-4638 | 2017-09-01 |
| 1700315462 | Nelson & Tillmann Family Dentistry, PC | Dentist | 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 | 2017-06-07 |
| 1437682002 | Salt Lake Dental Care | Dentist | 279 E 5900 S Ste 202, Salt Lake City, UT 84107-5425 | 2017-04-10 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84148 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.