JAKE PETERSON, DDS, MD
Oral and Maxillofacial Surgery (Dentist) · BEND, OR
Individual Active Opted out of Medicare NPI 1043657364
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | ✓ | D-5107-OS | ID |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | M-15171 | ID | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DE60941667 | WA |
Medicare eligibility
- Part B
- Yes
- DME
- Yes
- Home health
- Yes
- Power mobility
- No
- Hospice
- Yes
Opted out of Medicare (Oral Surgery), effective 2022-09-13 through 2026-09-13.
Other Oral and Maxillofacial Surgery (Dentist) providers in Oregon
- NPI 1598021578
- NPI 1023272119
- NPI 1588633515
- NPI 1801483318
- NPI 1689932063
- NPI 1619423787
- NPI 1750780441
- NPI 1245440676
See all Oral and Maxillofacial Surgery (Dentist) providers in Oregon →
Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.