DAVID PETERSON DDS
NPI 1215410584
Dentist - Oral and Maxillofacial Surgery in Dixon, IL

Q: What is David Peterson's NPI number?

The NPI number for David Peterson is 1215410584. It was assigned to this individual provider in the NPPES registry on September 12, 2018.

Q: What is David Peterson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: When was this NPI record last updated?

The NPPES record for David Peterson was last updated on September 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.

Active since September 12, 2018

1619 BRANDYWINE LN, DIXON, IL 61021(815) 622-4740 Get Directions Write a Review

NPPES record last updated: September 12, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About David Peterson Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAVID PETERSON DDS (NPI 1215410584) is an individual oral and maxillofacial surgery provider in Dixon, Illinois, licensed in Illinois (021001236) and active in the NPI registry since September 2018.

NPPES Registry Identity

NPI1215410584

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDAVID PETERSONCredential: DDS

Location Address1619 BRANDYWINE LNDixon, IL 61021-8757

Mailing Address1619 Brandywine LnDixon, IL 61021-8757 · (815) 622-4740

Phone(815) 622-4740

Sole ProprietorYes

Enumeration DateSeptember 12, 2018

✔ NPI 1215410584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in IL · 021001236

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

1619 BRANDYWINE LN, Dixon, IL 61021

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Other Identifiers 1

Other019017734IL · License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

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 David Peterson's NPI number?

The NPI number for David Peterson is 1215410584. It was assigned to this individual provider in the NPPES registry on September 12, 2018.

Where is David Peterson located?

David Peterson practices at 1619 Brandywine Ln, Dixon, IL 61021. The listed phone number is (815) 622-4740.

What is David Peterson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

What insurance does David Peterson accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Anthem Blue Cross and Blue Shield and BEST Life and 10 other insurers list David Peterson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for David Peterson was last updated on September 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.