DR. MARK CLAYTON PETERSON (NPI# 1871702076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871702076 |
| Entity Type | Individual |
| Full Name | DR. MARK CLAYTON PETERSON |
| Credential | D.D.S. |
| Practice Address |
1600 W Sunset Rd Ste B Henderson NV 89014-2655 |
| Practice Telephone | 7027338341 |
| Practice Fax Number | 7027332115 |
| Mailing Telephone | 7027338341 |
| Mailing Fax Number | 7027332115 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
S6-12 | NV | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164069696 | Mark Alan Peterson | In Home Supportive Care | 5870 Nw 54th Ct, Johnston, IA 50131-1418 | 2019-12-03 |
| 1841474012 | Mark Frederic Peterson I | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3351 36th St, Grand Rapids, MI 49331 | 2007-12-24 |
| 1780877258 | Mark A. Peterson | Counselor | 7322 Scenic Oaks Cir, Austin, TX 78745-5217 | 2007-08-19 |
| 1558481366 | Mark Theodore Peterson | Specialist | 5712 Newburg Rd, Rockford, IL 61108-6707 | 2007-03-29 |
| 1073608170 | Mark A Peterson | Dentist | 7740 Bay St, Suite # 1, Sebastian, FL 32958-3427 | 2006-10-04 |
| 1689782864 | Mark L Peterson | Dentist | 127 1/2 E Short St, Rigby, ID 83442-1422 | 2006-08-28 |
| 1528013661 | Mark Edward Peterson | Dentist | 2440 Gaynor Nw, Grand Rapids, MI 49544-1830 | 2006-05-24 |
| 1699763607 | Mark Delano Peterson | Orthopaedic Surgery | 1311 E Barnett Rd, Ste 201, Medford, OR 97504-8225 | 2005-10-12 |
| 1477551836 | Mark Dean Peterson | Chiropractor | 5406 Alderson St, Schofield, WI 54476-2264 | 2005-07-11 |
| 1477043842 | Mark Peterson | Student in an Organized Health Care Education/Training Program | 1115 20th St Ste 205, Huntington, WV 25703-2071 | 2018-05-11 |
| Street Address |
1600 W SUNSET RD STE B |
| City | HENDERSON |
| State | NV |
| Zip Code | 89014-2655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447857024 | Sudheer J. Surpure, Md, Dds, Inc. | Oral & Maxillofacial Surgery | Grand Canyon Oral and Facial Surgery, 1600 W. Sunset Road, Suite B, Henderson, NV 89014 | 2020-10-06 |
| 1386271740 | Fibonacci Services LLC | Counselor | 2920 N. Green Valley Pkwy, Bulding 8 & Suite 812, Henderson, NV 89014 | 2020-03-25 |
| 1508409145 | Facial Expressions Presented By K. Thomas | Home Infusion | 1520 W. Sunset Rd. Ste 130, #205, Henderson, NV 89014 | 2019-10-27 |
| 1235794595 | Marquise D Dennis | Prosthetist | 1520 W. Sunset Rd, Henderson, NV 89014 | 2019-05-02 |
| 1609359165 | Kenisha Voncille Thomas | Family Medicine | 1520 W Sunset Rd Ste 130, Henderson, NV 89014 | 2018-09-11 |
| 1841716727 | Logan Bretney | Physical Therapist | 400 S Stephanie St, Suite 310, Building 1, Henderson, NV 89014 | 2017-08-22 |
| 1912421280 | Alan Joseph Sevy | Dentist | 1485 W Warm Springs Rd Ste 101, Henderson, NV 89014 | 2017-07-28 |
| 1659805307 | Ann Marie Echevarria | Behavior Technician | 2551 N Green Valley Parkway, 410a, Henderson, NV 89014 | 2017-04-19 |
| 1366838997 | Ladwana Retic, Lcsw LLC | Case Management | 1514 Tree Top Ct, Henderson, NV 89014 | 2015-04-10 |
| 1073958393 | Ashlyn Call | Physician Assistant | 1397 Galleria Dr Ste 100, Henderson, NV 89014 | 2013-04-30 |
| Find all providers in zip 89014 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326537028 | Henderson Pediatric Dentistry PC | Dentist | 390 N Stephanie St Ste 104, Henderson, NV 89014-8029 | 2018-05-08 |
| 1457703290 | Wesley Archer | Dentist | 10400 S Eastern Ave, Henderson, NV 89052-3957 | 2016-07-05 |
| 1962843961 | Manny Rapp | Dentist | 1701 N. Green Valley Pkwy #8e, Henderson, NV 89074 | 2013-07-08 |
| 1699074112 | Rhonda L Kearney, Dds, Ms, Pllc | Dentist | 451 Ruin Creek Rd., 205, Henderson, NC 27536-0000 | 2011-03-23 |
| 1740485846 | Rhonda Louise Kearney | Dentist | 451 Ruin Creek Rd Ste 205, Henderson, NC 27536-5920 | 2007-06-19 |
| 1003939810 | Daniel William Sims Professional Corporation | Dentist | 375 N Stephanie St Bldg 6, Suite 611, Henderson, NV 89014-8771 | 2007-04-08 |
| 1841392172 | Chad W. Ellsworth | Dentist | 2843 St. Rose Pkwy, Suite 100, Henderson, NV 89052 | 2006-09-05 |
| 1740391465 | Laurence Jay Levine | Dentist | 2610 W Horizon Ridge Pkwy Ste 202, Henderson, NV 89052-2870 | 2006-08-31 |
| 1912924820 | Adaven Childrens Dentistry | Dentist | 1701 N Green Valley Parkway, #8e, Henderson, NV 89074 | 2006-07-16 |
| 1104879717 | Maryam Sina Dds Ltd | Dentist | 2551 N Green Valley Pkwy, Suite #400a, Henderson, NV 89014-0272 | 2006-05-18 |
| Find all providers in HENDERSON | ||||
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| 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.