Individual
JAKE ALLEN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
1475 SW CHANDLER AVE STE 101, BEND, OR 97702-3239
(541) 617-3993
Mailing address
1475 SW CHANDLER AVE STE 101, BEND, OR 97702-3239
(541) 617-3993
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D-5107-OS
ID
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DE60941667
WA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
M-15171
ID
Other
Enumeration date
05/28/2013
Last updated
03/01/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us