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

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1043657364

Jake Allen Peterson, DDS, MD is an Oral and Maxillofacial Surgery (Dentist) in Bend, Oregon. Practices as a sole proprietor and works from 2 locations. Licensed in Idaho and Washington.

Licensed in
ID, WA
In the registry since
2013
Specialties on file
3
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.
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1475 SW Chandler Ave Ste 101
Bend, OR 97702-3239
Phone: (541) 617-3993
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1475 Ne Williamson Blvd, Bend, OR 97701-6038 — (541) 382-1053

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence D-5107-OS (ID)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence M-15171 (ID)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence DE60941667 (WA)

Record details

NPI number1043657364
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS , MD
Sole proprietorYes
NPI enumeratedMay 28, 2013
Last updated in NPPESMarch 1, 2022
Certification dateMarch 1, 2022

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