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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JAKE ALLEN PETERSON, DDS, MD

Active Sole Proprietor

JAKE ALLEN PETERSON, DDS, MD is a Oral & Maxillofacial Surgery healthcare provider located in BEND, Oregon. NPI 1043657364 is currently active in the NPPES registry. Verify at CMS.

Oral & Maxillofacial Surgery · BEND, OR

Registration Details

NPI Number
1043657364
Provider Type
Individual
Gender
Male
NPI Issued
May 28, 2013 (13.177481110856 yrs)
Last Updated
Mar 1, 2022
Licenses
M-15171 (ID)
DE60941667 (WA)
D-5107-OS (ID)
Sole Proprietor
Yes

Practice Information

Address
1475 SW CHANDLER AVE STE 101
BEND, OR, 977023239
Browse OR providers · Browse ZIP 97702
Phone
5416173993
Primary Specialty
Oral & Maxillofacial Surgery
1223S0112X
Additional Specialty
Oral & Maxillofacial Surgery
Additional Specialty
Oral & Maxillofacial Surgery

Other Oral & Maxillofacial Surgery Providers in BEND, OR

Name Credential NPI
DR. DONALD CHARLES DELISI JR. D.M.D. 1588633515
DR. STEVEN MARSHALL ROGERS DMD 1992810154
NATHAN D LENOX DMD, MD 1245440676
AMIR AZARISAMANI MD, DMD 1598021578
GARRETT WELCH DDS 1689932063
DR. MARK SCHLAM DMD 1750780441
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.