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

Dr. Jason Dayne Petersen, MD

Individual provider Plastic Surgery Physician · NPI 1215105804

Dr. Jason Dayne Petersen, MD is a Plastic Surgery Physician in Salt Lake City, Utah. Licensed in Utah. Registered with an NPI since 2008.

Licensed in
UT
In the registry since
2008
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

5353 S 960 E #150
Salt Lake City, UT 84117-3569
Phone: (801) 261-5791
Fax: (801) 747-7740
Show map & directions

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

Specialties & licences

Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician (primary) Taxonomy 2082S0099X · Licence 83185641205 (UT)
Plastic Surgery Physician Taxonomy 208200000X · Licence 83185641205 (UT)

Record details

NPI number1215105804
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 15, 2008
Last updated in NPPESAugust 7, 2012

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