PETERSON DENTAL PC
NPI 1114477692
Specialist in Oceanside, NY
About Peterson Dental Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PETERSON DENTAL PC (NPI 1114477692) is a healthcare organization registered as a specialist in Oceanside, New York and active in the NPI registry since October 2016. The organization lists John Peterson, Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Peterson Dental Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Peterson Dental PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Peterson Dental PC's NPI number?
The NPI number for Peterson Dental PC is 1114477692. It was assigned to this organization in the NPPES registry on October 10, 2016.
Where is Peterson Dental PC located?
Peterson Dental PC is located at 2983 Long Beach Rd, Oceanside, NY 11572. The listed phone number is (516) 536-5777.
What is Peterson Dental PC's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Peterson Dental PC enrolled in Medicare?
Yes. Peterson Dental PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Peterson Dental PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Oral Surgery) reassigns their Medicare billing to Peterson Dental PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Peterson Dental PC was last updated on February 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Peterson Dental Pc · NPI 1114477692
Specialist organization in Oceanside, New York. Organization record, active in the CMS NPPES registry since October 10, 2016.
## Identity
- **NPI:** 1114477692 (Entity type: Organization)
- **Enumerated:** October 10, 2016
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** John Peterson, OFFICER
## Practice location
- **Address:** 2983 LONG BEACH RD, Oceanside, NY 11572-3204
- **Phone:** (516) 536-5777
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Oral Surgery) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 18, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1114477692) · Data from the CMS NPPES public registry.