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KELSEY PETERSON DMD
NPI 1396069712
Dentist - General Practice in Emmett, ID

Active since March 15, 2010
1312 SOUTH WASHINGTON STREET, EMMETT, ID 83617(208) 941-6640 Get Directions Write a Review

NPPES record last updated: February 13, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelsey Peterson Dmd NPPES

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

KELSEY PETERSON DMD (NPI 1396069712) is an individual general practice provider in Emmett, Idaho, licensed in Idaho (D-4282) and active in the NPI registry since March 2010.

NPPES Registry Identity

NPI1396069712
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameKELSEY PETERSONCredential: DMD
Location Address1312 SOUTH WASHINGTON STREETEmmett, ID 83617
Mailing Address1312 S Washington Ave Ste CEmmett, ID 83617-3596 · (208) 365-6800 · Fax (208) 365-9600
Phone(208) 941-6640
Sole ProprietorYes
Enumeration DateMarch 15, 2010
Last NPPES UpdateFebruary 13, 2024
NPPES CertifiedFebruary 13, 2024
✔ NPI 1396069712 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in ID · D-4282
Definition
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.
Also ListedDentist · Orthodontics and Dentofacial OrthopedicsTaxonomy 1223X0400X · License D-4282-OR (ID)
1312 SOUTH WASHINGTON STREET, Emmett, ID 83617
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana 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 Kelsey Peterson's NPI number?

The NPI number for Kelsey Peterson is 1396069712. It was assigned to this individual provider in the NPPES registry on March 15, 2010.

Where is Kelsey Peterson located?

Kelsey Peterson practices at 1312 South Washington Street, Emmett, ID 83617. The listed phone number is (208) 941-6640.

What is Kelsey Peterson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Kelsey Peterson accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 7 other insurers list Kelsey 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 Kelsey Peterson was last updated on February 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.