DR. BENJAMIN ROBERT PETERSON (NPI# 1801052915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801052915 |
| Entity Type | Individual |
| Full Name | DR. BENJAMIN ROBERT PETERSON |
| Credential | DDS |
| Practice Address |
424 South St. Waterloo IA 50701 |
| Practice Telephone | 3192342684 |
| Practice Fax Number | 3192335974 |
| Mailing Telephone | 3192342684 |
| Mailing Fax Number | 3192335974 |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2010-10-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | D12600 | MN | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
08702 | IA | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
D12600 | MN | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083987903 | Benjamin David Peterson | Counselor | 4455 Ne Hw 20, Children's Farm Home, Corvallis, OR 97330 | 2012-02-23 |
| 1922341015 | Benjamin Evans Peterson | Student in an Organized Health Care Education/Training Program | 2301 Erwin Rd, Durham, NC 27705-4699 | 2013-03-27 |
| 1720159080 | Benjamin T Peterson | Dentist | 271 Sw 13th St, Ontario, OR 97914-4530 | 2006-11-10 |
| Street Address |
424 SOUTH ST. |
| City | WATERLOO |
| State | IA |
| Zip Code | 50701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659672038 | William C. Bolick D.ds L.L.C. | Dentist | 424 South St., Waterloo, IA 50701-1516 | 2010-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548757586 | Shawna Harvey | Optometrist | 999 Home Plz Ste 100, Waterloo, IA 50701 | 2018-04-16 |
| 1831693290 | Blue Gregory Boyer | Counselor | 3362 University Ave., Waterloo, IA 50701 | 2018-03-21 |
| 1518460666 | Tom Taylor | Specialist | 974 Home Plaza, Waterloo, IA 50701 | 2018-03-15 |
| 1194247551 | Homelink Sanford | Durable Medical Equipment & Medical Supplies | 1111 W San Marnan Drive, Waterloo, IA 50701 | 2017-07-07 |
| 1932471109 | Walgreens | Pharmacy | 111 W Ridgeway Avenue, Waterloo, IA 50701 | 2012-02-03 |
| 1598055188 | Knox Eyecare | Optometrist | 1030 Alabar Ave., Waterloo, IA 50701 | 2011-04-15 |
| 1013222330 | Ashley Lynn Charmichael | Dentist | 220 W. Ridgeway Ave., Suite 201, Waterloo, IA 50701 | 2010-08-11 |
| 1396062311 | Gwendoline Fang | Obstetrics & Gynecology | 1015 S. Hackett Road Suite 200, Department of Ob/gyn, Waterloo, IA 50701 | 2010-04-29 |
| 1013234194 | Ryan Norman Borgwardt | Dentist | 820 Fisher Drive, Waterloo, IA 50701 | 2010-04-28 |
| 1629302310 | Rhonda Kay Herum | Social Worker | 3731 Pheasant Lane #203, Waterloo, IA 50701 | 2009-09-28 |
| Find all providers in zip 50701 | ||||
| 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 |
|---|---|---|---|---|
| 1659753069 | Hannah Rose Leuschen | Dentist | 4015 Hurst Dr, Waterloo, IA 50701-9035 | 2015-06-22 |
| 1437571320 | Waterloo Family Dental | Dentist | 245 N. Monroe Street, Waterloo, WI 53594 | 2014-01-10 |
| 1164773735 | Stephen Frederick Hartman | Dentist | 107 North Virginia Street, Waterloo, NY 13165 | 2012-09-24 |
| 1447400791 | Dr John F Blattner & Dr Dwight D Heberer PC | Dentist | 226 Westview Plaza Dr, Waterloo, IL 62298-1253 | 2008-09-23 |
| 1720236128 | Bradley W Mitchell | Dentist | 413 W 3rd St, Waterloo, IL 62298-1358 | 2008-08-28 |
| 1386808079 | Christopher Glenn Eastman | Dentist | 2765 Crossroads Blvd, Waterloo, IA 50702 | 2008-07-11 |
| 1033237318 | Dr Darryll L Beard Dmd Ltd | Dentist | 208 Bradford Lane, Waterloo, IL 62298 | 2007-03-26 |
| 1043363757 | Martin E. Averill | Dentist | 2102 Kimball Ave, Waterloo, IA 50702-5037 | 2007-01-18 |
| 1487703286 | Larry G Payne | Dentist | 605 S Wayne St, Waterloo, IN 46793-9472 | 2007-01-09 |
| 1689730327 | John Vernon Jetty | Dentist | 86 Center St, Waterloo, NY 13165-1026 | 2006-12-28 |
| Find all providers in WATERLOO | ||||
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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.