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COLLIN B PETERSON DMD DENTISTRY PLLC
NPI 1447059019
Dentist - General Practice in Diberville, MS

Active since March 07, 2025
10409 BONEY AVE, DIBERVILLE, MS 39540(228) 216-7853 Get Directions Write a Review

NPPES record last updated: February 12, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 7, 2025, Mar 7, 2025 (2 updates tracked since 2025).

About Collin B Peterson Dmd Dentistry Pllc NPPES

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

COLLIN B PETERSON DMD DENTISTRY PLLC (NPI 1447059019) is a healthcare organization registered as a general practice in Diberville, Mississippi and active in the NPI registry since March 2025. The organization lists Collin Peterson, Dentist/owner, as its authorized official.

NPPES Registry Identity

NPI1447059019
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameCOLLIN B PETERSON DMD DENTISTRY PLLC
Location Address10409 BONEY AVEDiberville, MS 39540-4813
Mailing Address10409 Boney AveDiberville, MS 39540-4813 · (228) 809-8822 · Fax (228) 400-1240
Phone(228) 216-7853
Organization SubpartNo
Authorized OfficialCollin PetersonDentist/owner · (228) 216-7853
Enumeration DateMarch 7, 2025
Last NPPES UpdateFebruary 12, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 12, 2026
✔ NPI 1447059019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
10409 BONEY AVE, Diberville, MS 39540
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

STEVEN K MINER
Dentist
10409 BONEY AVE
DIBERVILLE, MS 39540
Harrison County (228) 424-0145
BACK BAY FAMILY DENTISTRY
Dentist (General Practice)
10409 BONEY AVE
DIBERVILLE, MS 39540
Harrison County (228) 392-0509
DR. COLLIN PETERSON DMD
Dentist
10409 BONEY AVE
DIBERVILLE, MS 39540
Harrison County (228) 809-8822

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 Collin B Peterson Dmd Dentistry PLLC's NPI number?

The NPI number for Collin B Peterson Dmd Dentistry PLLC is 1447059019. It was assigned to this organization in the NPPES registry on March 7, 2025.

Where is Collin B Peterson Dmd Dentistry PLLC located?

Collin B Peterson Dmd Dentistry PLLC is located at 10409 Boney Ave, Diberville, MS 39540. The listed phone number is (228) 216-7853.

What is Collin B Peterson Dmd Dentistry PLLC'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 Collin B Peterson Dmd Dentistry PLLC was last updated on February 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.