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DR. TYSON PETERESN
NPI 1972121770
Clinic/Center - Dental in Logan, UT

Active since July 08, 2020
110 E 200 N, LOGAN, UT 84321(435) 752-0300(435) 755-7625 Get Directions Write a Review

NPPES record last updated: July 8, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Tyson Peteresn NPPES

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

DR. TYSON PETERESN (NPI 1972121770) is a healthcare organization registered as a dental in Logan, Utah and active in the NPI registry since July 2020. The organization lists Tyson Petersen, Dr, as its authorized official.

NPPES Registry Identity

NPI1972121770
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameDR. TYSON PETERESN
Location Address110 E 200 NLogan, UT 84321-4007
Mailing Address110 E 200 NLogan, UT 84321-4007 · (435) 752-0300 · Fax (735) 755-7625
Phone(435) 752-0300
Fax(435) 755-7625
Organization SubpartNo
Authorized OfficialTyson PetersenDr · (435) 752-0300
Enumeration DateJuly 8, 2020
NPPES CertifiedJuly 8, 2020
✔ NPI 1972121770 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
110 E 200 N, Logan, UT 84321
Open in Google Maps ↗

Other Identifiers 1

OtherPE1UT · Dental

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES 2

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

DR. GARY FOSTER DDS
Clinic/Center (Dental)
110 E 200 N
LOGAN, UT 84321
Cache County (435) 752-0300
GARY GEORGE FOSTER DDS
Dentist (General Practice)
110 E 200 N
LOGAN, UT 84321
Cache County (435) 752-0300

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 Dr. Tyson Peteresn's NPI number?

The NPI number for Dr. Tyson Peteresn is 1972121770. It was assigned to this organization in the NPPES registry on July 8, 2020.

Where is Dr. Tyson Peteresn located?

Dr. Tyson Peteresn is located at 110 E 200 N, Logan, UT 84321. The listed phone number is (435) 752-0300.

What is Dr. Tyson Peteresn's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

What insurance does Dr. Tyson Peteresn accept?

Health plans from UnitedHealthcare list Dr. Tyson Peteresn 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 Dr. Tyson Peteresn was last updated on July 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.