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PETERSON DENTAL ASSOCIATES, P.A.
NPI 1396856100
Dentist - General Practice in St Cloud, MN

Active since August 31, 2006
816 W ST GERMAIN ST #101, ST CLOUD, MN 56301(320) 252-2454(320) 252-2232 Get Directions Write a Review

NPPES record last updated: June 17, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Peterson Dental Associates, P.a. NPPES

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

PETERSON DENTAL ASSOCIATES, P.A. (NPI 1396856100) is a healthcare organization registered as a general practice in St Cloud, Minnesota and active in the NPI registry since August 2006. The organization lists Russell Thomas Peterson, President Of Corp, as its authorized official.

NPPES Registry Identity

NPI1396856100
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePETERSON DENTAL ASSOCIATES, P.A.
Location Address816 W ST GERMAIN ST #101St Cloud, MN 56301-3511
Mailing Address816 W St Germain St #101St Cloud, MN 56301-3511 · (320) 252-2454 · Fax (320) 252-2232
Phone(320) 252-2454
Fax(320) 252-2232
Organization SubpartNo
Authorized OfficialRussell Thomas PetersonPresident Of Corp · (320) 252-2454
Enumeration DateAugust 31, 2006
Last NPPES UpdateJune 17, 2014
✔ NPI 1396856100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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 ListedDental HygienistTaxonomy 124Q00000X
Also ListedDental AssistantTaxonomy 126800000X
816 W ST GERMAIN ST #101, St Cloud, MN 56301
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Other Identifiers 1

Medicaid398350100MN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. THOMAS MERLIN PETERSON DDS
Dentist (General Practice)
816 W ST GERMAIN ST #101
ST CLOUD, MN 56301
Stearns County (320) 252-2454

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 Associates, P.A.'s NPI number?

The NPI number for Peterson Dental Associates, P.A. is 1396856100. It was assigned to this organization in the NPPES registry on August 31, 2006.

Where is Peterson Dental Associates, P.A. located?

Peterson Dental Associates, P.A. is located at 816 W St Germain St #101, St Cloud, MN 56301. The listed phone number is (320) 252-2454.

What is Peterson Dental Associates, P.A.'s specialty?

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

When was this NPI record last updated?

The NPPES record for Peterson Dental Associates, P.A. was last updated on June 17, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.