DR. KELLY B PETERSON (NPI# 1558399261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558399261 |
| Entity Type | Individual |
| Full Name | DR. KELLY B PETERSON |
| Credential | D.D.S. |
| Practice Address |
5100 Grove St Ste B Marysville WA 98270-4492 |
| Practice Telephone | 3606587750 |
| Practice Fax Number | 3606581297 |
| Mailing Telephone | 3606587750 |
| Mailing Fax Number | 3606581297 |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2009-10-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
6879 | WA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013450907 | Kelly Rose Peterson | Physical Therapist | 1190 Baker St Ste 105, Costa Mesa, CA 92626-4105 | 2016-11-23 |
| 1326437120 | Kelly Leigh Peterson | Nurse Practitioner | 2200 Childrens Way Monroe Carell Jr, Doctor's Office Tower, 7th Floor, Suite 7100, Nashville, TN 37232-0001 | 2015-01-16 |
| 1336424027 | Kelly Rae Peterson | Nurse Anesthetist, Certified Registered | 9803 Vagabond Ln N, Maple Grove, MN 55311-1364 | 2011-10-13 |
| 1235413758 | Kelly Suzanne Peterson | Naturopath | 638 Fulton St W Suite B, Grand Rapids, MI 49504 | 2011-10-03 |
| 1710016563 | Kelly Peterson | Counselor | 5240 Ne Elam Young Pkwy Ste 100, Hillsboro, OR 97124 | 2007-03-05 |
| 1639787872 | Kelly Peterson | Military Health Care Provider | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-07-14 |
| 1255965208 | Kelly A Peterson | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-02-28 |
| 1639720014 | Kelly Ann Peterson | Counselor | 20288 Highway 15 N Ste 100, Hutchinson, MN 55350-5685 | 2019-09-26 |
| 1164087730 | Kelly Peterson | Registered Nurse | 410 W 10th Ave, Columbus, OH 43210-1240 | 2019-05-08 |
| 1366923963 | Kelly Peterson | Counselor | 205 Burlington Rd, Bedford, MA 01730-1406 | 2018-08-22 |
| Street Address |
5100 GROVE ST STE B |
| City | MARYSVILLE |
| State | WA |
| Zip Code | 98270-4492 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659387645 | Beth Anne Gold | Dentist | 5100 Grove St, Suite A, Marysville, WA 98270-4492 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730706631 | Amy Jean Tuengel | Massage Therapist | 4731 61st Ne, Marysville, WA 98270 | 2020-06-26 |
| 1821569534 | Andrew M Reid | Physical Therapist | Marysville Physical Therapy, 919 State Avenue Suite 101, Marysville, WA 98270 | 2018-12-07 |
| 1861989162 | Jenna Celine Schmidt | Student in an Organized Health Care Education/Training Program | Seamar Marysville Family Medicine Residency Program, 9710 State Ave, Marysville, WA 98270 | 2018-04-23 |
| 1497103162 | Kyoung Craddock | Registered Nurse | 5722 65th St Ne, Marysville, WA 98270 | 2016-06-02 |
| 1235553348 | Marysville School District | Speech-Language Pathologist | 4220 80th Street Ne, Marysville School District, Marysville, WA 98270 | 2014-02-10 |
| 1386085694 | Malgorzata Cassidy | Counselor | 4308 76th. St. Ne, Marysville, WA 98270 | 2013-07-15 |
| 1972852374 | Suzanne Leboeuf | Counselor | 1227 2nd St., Marysville, WA 98270 | 2012-08-31 |
| 1508121161 | Tricia Nicole Davis | Pharmacy Technician | 6602 74th St Ne, Marysville, WA 98270 | 2012-07-10 |
| 1962774216 | Lynae Marie Swinheart | Community/Behavioral Health | 6418 66th Pl Ne, Marysville, WA 98270 | 2012-02-02 |
| 1598042459 | Jamie Rae Isaacson | Speech-Language Pathologist | 1820 Grove St., Marysville, WA 98270 | 2011-11-07 |
| Find all providers in zip 98270 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386292530 | Marysville Dental Group | Dentist | 17791 State Route 31, Marysville, OH 43040-9607 | 2019-08-30 |
| 1053869479 | Family Dental Care In Marysville | Dentist | 11580 Us Rt 36 E, Marysville, OH 43040-8512 | 2016-09-14 |
| 1225333578 | Kathryn K Montgomery Dds LLC | Dentist | 15580 Us Rt 36e, Marysville, OH 43040 | 2011-01-18 |
| 1558681866 | Holly Eydenberg | Dentist | 3943 116th St Ne, Ste. 103, Marysville, WA 98271-8448 | 2010-06-09 |
| 1730311168 | Park and Ghorbanian Dds, Pllc #2 | Dentist | 1603 Grove St, Marysville, WA 98270-4301 | 2009-08-19 |
| 1992930226 | Scott Gallagher Shaw | Dentist | 2704 171st Pl Ne, Marysville, WA 98271 | 2009-05-15 |
| 1336385541 | All Smiles Family Dental | Dentist | 15580 Us Highway 36, Marysville, OH 43040-9415 | 2008-12-18 |
| 1770793069 | Kathryn Kalkreuth Montgomery | Dentist | 15580 State Route 36, Marysville, OH 43040-9415 | 2007-05-23 |
| 1235349887 | Kent Hawkins | Dentist | 1051 Lydia Dr Ste 200, Marysville, OH 43040-7081 | 2007-05-23 |
| 1285848218 | Hae Su Yim | Dentist | 1127 W 5th St, Marysville, OH 43040-9282 | 2007-05-09 |
| Find all providers in MARYSVILLE | ||||
| City | MARYSVILLE |
| Zip Code | 98270 |
Please comment or provide details below to improve the information on DR. KELLY B PETERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.