Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Peterson Orthodontics & Periodontics, LLC

Organization Periodontics · NPI 1457875700

Peterson Orthodontics & Periodontics, LLC is a Periodontics in Lake Oswego, Oregon. Licensed in Oregon. Registered with an NPI since 2017.

Licensed in
OR
In the registry since
2017
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

15962 Boones Ferry Rd Ste 108
Lake Oswego, OR 97035-4359
Phone: (503) 699-6569
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthodontics and Dentofacial Orthopedics Dentistry (primary) Taxonomy 1223X0400X (OR)
Periodontics Taxonomy 1223P0300X (OR)

Record details

NPI number1457875700
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Vanessa Peterson — Orthodontist, Member Of Llc · (909) 518-7743
Other names Lake Oswego Orthodontics; Lake Oswego Orthodontics & Periodontics; Lake Oswego Periodontics
NPI enumeratedJuly 28, 2017
Last updated in NPPESJune 16, 2018
Mailing address4420 Se 51st Ave, Portland, OR 97206-3910

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