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

Dr. Tyson Don Petersen, DDS

Individual provider General Practice Dentistry · NPI 1457806457

Dr. Tyson Don Petersen, DDS is a General Practice Dentistry in Logan, Utah. Licensed in Idaho and Utah. Registered with an NPI since 2016.

Licensed in
ID, UT
In the registry since
2016
Specialties on file
2
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.

See every abbreviation used in this directory →

Practice location Address checks out

1260 N 200 E
Logan, UT 84341-7560
Phone: (435) 752-8000
Show map & directions

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

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 10387670-9923 (UT)
General Practice Dentistry Taxonomy 1223G0001X · Licence 4774 (ID)

Record details

NPI number1457806457
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedAugust 18, 2016
Last updated in NPPESJuly 21, 2022
Mailing address763 E 350 S, Smithfield, UT 84335-1325

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