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Peterson Dental Associates, P.A.

General Practice Dentistry in St Cloud, MN · enumerated 2006 · authorized official Russell Peterson, President of Corp.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1396856100

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Registry record

Entity type Organization (Type 2)
Legal business name Peterson Dental Associates, P.A.
Practice address 816 W St Germain St #101, St Cloud, MN, 56301
Phone (320) 252-2454
Fax (320) 252-2232
Enumeration date Aug 31, 2006
Last updated in NPPES Jun 17, 2014

Taxonomy & classification

1223G0001X General Practice Dentistry Dental Providers Primary
124Q00000X Dental Hygienist Dental Providers Secondary
126800000X Dental Assistant Dental Providers Secondary

Authorized official

Name Russell Peterson
Title President of Corp
Phone (320) 252-2454

Other identifiers

Identifier Type State Issuer
398350100 Medicaid MN -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Peterson Dental Associates, P.A.?
Peterson Dental Associates, P.A. is registered in NPPES as a General Practice Dentistry (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-06-17.