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

Dr. Mark Edward Peterson, DDS

Individual provider Dentist · NPI 1528013661

Dr. Mark Edward Peterson, DDS is a Dentist in Grand Rapids, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

2440 Gaynor NW
Grand Rapids, MI 49544-1830
Phone: (616) 784-8444
Fax: (616) 784-6912
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 13556 (MI)

Record details

NPI number1528013661
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedMay 24, 2006
Last updated in NPPESMarch 14, 2019
Mailing address2440 Gaynor Nw, Grand Rapids, MI 49544-1830

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