Nathaniel J. Peterson, DMD

Dentist · Edwardsville, IL

Individual Active NPI

NPI number 1871489047

Practice location

1403b Troy Rd Ste B
Edwardsville, IL 62025-2532
Phone
(618) 656-2277
Fax
(618) 656-7732

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NPI record

NPI
1871489047
Entity type
Individual (Type 1)
Enumeration date
June 16, 2025
Last updated
June 16, 2025
Certified
June 16, 2025
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 019036159 IL

Mailing address

837 Madison Ave
Edwardsville, IL 62025-2323
Phone
(630) 618-9211

About Dr. Peterson

Nathaniel J. Peterson, DMD is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 1403b Troy Rd Ste B, Edwardsville, IL 62025-2532. The NPI number 1871489047 was assigned on June 16, 2025 and the record was last updated on June 16, 2025.

Dr. Peterson lists a license in the registry: #019036159 (IL) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Nathaniel J. Peterson, DMD?

The NPI number is 1871489047.

What is the phone number of Dr. Peterson?

The phone number listed for the practice location is (618) 656-2277.

Where is Dr. Peterson located?

1403b Troy Rd Ste B, Edwardsville, IL 62025-2532.

What is the taxonomy code for Dr. Peterson?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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