IndividualActive
Justin Peterson, D.D.S.
NPI 1386955029 · General Practice Dentistry · Saint Anthony, ID
Provider details
- NPI number
- 1386955029
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- No
- License
- D4293 (ID)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 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
325 E Main St
Saint Anthony, ID 83445-1546
Phone: (208) 356-4900
Fax: (208) 624-4117
Street-level locationGet directions
Mailing address
Po Box 18
Saint Anthony, ID 83445-0018
Additional practice locations (1)
- 72 S 1st ERexburg, ID 83440-1902Phone: (208) 356-4900Fax: (208) 356-3724
Registry dates
- Enumerated
- 2010-06-28
- Last updated
- 2022-05-17
- Certified
- 2022-05-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.