NPI age
3 years
Enumerated 2022-07-27
● Active Type 2 · Organization
Tayne A Peterson DMD Pllc
Tayne A Peterson DMD Pllc is 1 of 202 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Peterson
Sole Mbr
Last NPPES update
2022-09-07
Source: monthly bulk 2026-05
How this organization compares
Across 202 active clinic/center providers in Idaho.
NPI age
3 years
↓ 5 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2022 → 2026
2022-07Enumerated in NPPES
2022
2026
Where they practice
Primary practice location
2200 Park Ave Ste 2
Burley, ID 833182186
Mailing address
2200 Park Ave Ste 2
Burley, ID 833182186
Authorized official
Tayne Peterson, DMD
Sole Mbr
📞 2086704428
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Tayne Peterson Dentist NPI 1952960205
Specialties
-
Clinic/Center PrimaryDefinition to come...
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
BURLEY FAMILY DENTAL
-
BURLEY FAMILY DENTAL
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.