Nicholas Dee Petersen, DDS

General Practice Dentistry · Provo, UT

Individual Active NPI

NPI number 1912790965

Practice location

1234 N 900 E Ste 100
Provo, UT 84604-2726
Phone
(801) 854-9140

Open in Google Maps

NPI record

NPI
1912790965
Entity type
Individual (Type 1)
Enumeration date
May 23, 2025
Last updated
May 23, 2025
Certified
May 23, 2025
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 14223904-9926 UT

Mailing address

1573 W Morning View Way
Lehi, UT 84043-7733
Phone
(503) 475-5812

About Dr. Petersen

Nicholas Dee Petersen, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 1234 N 900 E Ste 100, Provo, UT 84604-2726. The NPI number 1912790965 was assigned on May 23, 2025 and the record was last updated on May 23, 2025.

Dr. Petersen lists a license in the registry: #14223904-9926 (UT) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Nicholas Dee Petersen, DDS?

The NPI number is 1912790965.

What is the phone number of Dr. Petersen?

The phone number listed for the practice location is (801) 854-9140.

Where is Dr. Petersen located?

1234 N 900 E Ste 100, Provo, UT 84604-2726.

What is the taxonomy code for Dr. Petersen?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

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.

Other General Practice Dentistry providers in Provo

All General Practice Dentistry providers in Provo, UT →