Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1407613425 Individual Practitioner Male Practitioner

Dr. Jacob Dean Peterson , DDS

Dentist • Casper, WY

Professional Overview & Biography Verified Profile Summary

Dr. Jacob Peterson, DDS is a registered healthcare professional specializing in Dentist in Casper, WY. Practice services are available at 5000 BLACKMORE RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

5000 Blackmore Rd

Casper, WY 826093345

Telephone 3072336000
Fax 3072336019
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Casper, WY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
23 Specialists

Practicing in Casper, WY (158 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-01-29
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License WY 1679

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Barbara Sovine , RN

Registered Nurse

NPI 1003016874

Registered Nurse

Travis Scoresby , PA-C

Physician Assistant

NPI 1003167594

Physician Assistant (Certified)

William Maurer , LCSW

Social Worker - Clinical

NPI 1003976267

Licensed Clinical Social Worker

Mary Lembke , RN

Registered Nurse - Women's Health Care, Ambulatory

NPI 1033236054

Registered Nurse

Sara Malsom , PA-C

Physician Assistant

NPI 1033528666

Physician Assistant (Certified)

Abigail Arross

Nurse Practitioner - Family

NPI 1033750716

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location January 29, 2025

Registered at 5000 BLACKMORE RD, CASPER, WY 826093345 (Tel: 3072336000)

📍
Updated Business Mailing Address January 29, 2025

Registered at 5000 BLACKMORE RD, CASPER, WY 826093345 (Tel: 3072336000)

📍
Updated Practice Location July 10, 2024

Registered at 1716 WARREN AVE, CHEYENNE, WY 820014538 (Tel: 3076320565)

👤
Provider Name / Credentials Updated July 10, 2024

Recorded as JACOB PETERSON, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 10, 2024

Dentist (License #1679 in WY)

NPI Profile Active March 05, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location March 05, 2024

Registered at 510 STAR VALLEY DR, CHEYENNE, WY 820098552 (Tel: 3072218090)

📍
Updated Business Mailing Address March 05, 2024

Registered at 510 STAR VALLEY DR, CHEYENNE, WY 820098552 (Tel: 3072218090)

👤
Provider Name / Credentials Updated March 05, 2024

Recorded as JACOB PETERSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 05, 2024

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 05, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1407613425
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 05, 2024
Last Update: January 29, 2025
Sole Proprietor: No

Mailing Address

5000 Blackmore Rd

Casper, WY 826093345

Phone: 3072336000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.