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DR. RUSSELL THOMAS PETERSON DDS
NPI 1457513616
Dentist in Saint Cloud, MN

Active since June 30, 2008PECOS Enrolled
816 W SAINT GERMAIN ST, SUITE 101, SAINT CLOUD, MN 56301(320) 252-2454(320) 252-2232 Get Directions Write a Review

NPPES record last updated: May 14, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Russell Thomas Peterson Dds NPPES

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

DR. RUSSELL THOMAS PETERSON DDS (NPI 1457513616) is an individual dentist in Saint Cloud, Minnesota, licensed in Minnesota (D12530) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457513616
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. RUSSELL THOMAS PETERSONCredential: DDS
Location Address816 W SAINT GERMAIN ST, SUITE 101Saint Cloud, MN 56301-4502
Mailing Address816 W Saint Germain St, Suite 101Saint Cloud, MN 56301-4502 · (320) 252-2454 · Fax (320) 252-2232
Phone(320) 252-2454
Fax(320) 252-2232
Sole ProprietorNo
Enumeration DateJune 30, 2008
Last NPPES UpdateMay 14, 2009
✔ NPI 1457513616 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MN · D12530
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
816 W SAINT GERMAIN ST, Saint Cloud, MN 56301
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Russell Thomas Peterson Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

JOHN P MILEY LAC
Acupuncturist
816 W SAINT GERMAIN ST, STE. 201
SAINT CLOUD, MN 56301
Stearns County (320) 656-1010

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 Russell Peterson's NPI number?

The NPI number for Russell Peterson is 1457513616. It was assigned to this individual provider in the NPPES registry on June 30, 2008.

Where is Russell Peterson located?

Russell Peterson practices at 816 W Saint Germain St Suite 101, Saint Cloud, MN 56301. The listed phone number is (320) 252-2454.

What is Russell Peterson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Russell Peterson enrolled in Medicare?

Yes. Russell Peterson is registered in the Medicare PECOS enrollment system.

What insurance does Russell Peterson accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and HRI Dental & Vision and 3 other insurers list Russell 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 Russell Peterson was last updated on May 14, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.