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

Tayne a Peterson DMD PLLC

Organization Dental Clinic/Center · NPI 1942936406

Tayne a Peterson DMD PLLC is a Dental Clinic/Center in Burley, Idaho. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

2200 Park Ave Ste 2
Burley, ID 83318-2186
Phone: (208) 878-6684
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1942936406
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tayne Peterson — Sole Mbr · (208) 670-4428
Other names Burley Family Dental; Burley Family Dental
NPI enumeratedJuly 27, 2022
Last updated in NPPESSeptember 7, 2022
Certification dateSeptember 7, 2022
Mailing address2200 Park Ave Ste 2, Burley, ID 83318-2186

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