NPI age
6 years
Enumerated 2019-06-14
● Active
Type 1 · Individual
Ty Peterson, DMD
Peterson is 1 of 4 dentist providers in Gooding and 1 of 1099 in Idaho.
Primary specialty
Dentist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2019-06-14
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 1099 active dentist providers in Idaho.
NPI age
6 years
↓ 12 yr below median (18 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
0
12% of peers hold subspecialties
NPI lifetime · 2019 → 2026
2019-06Enumerated in NPPES
2019
2026
Where they practice
Practice location
325 Main St
Gooding, ID 833301302
Mailing address
325 Main St
Gooding, ID 833301302
Specialties
-
Dentist PrimaryA general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Practice context
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.