IndividualActive
Jake Peterson, DDS, MD
NPI 1043657364 · Oral and Maxillofacial Surgery (Dentist) · Bend, OR
Provider details
- NPI number
- 1043657364
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- DDS, MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- M-15171 (ID)
Specialties & taxonomies
Dental Providers
Dental Providers
Dental Providers
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1475 Sw Chandler Ave Ste 101
Bend, OR 97702-3239
Phone: (541) 617-3993
Street-level locationGet directions
Mailing address
1475 Sw Chandler Ave Ste 101
Bend, OR 97702-3239
Additional practice locations (1)
- 1475 Ne Williamson BlvdBend, OR 97701-6038Phone: (541) 382-1053
Registry dates
- Enumerated
- 2013-05-28
- Last updated
- 2022-03-01
- Certified
- 2022-03-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.