Tayne Peterson, - Dentist in Burley, ID

Tayne Peterson, is a Dentist - General Practice based in Burley, Idaho. Tayne Peterson is licensed to practice in Idaho (license number D-5401) and his current practice location is 2200 Park Ave Ste 2, Burley, Idaho. He can be reached at his office (for appointments etc.) via phone at (208) 878-6684.

NPI number for Tayne Peterson is 1952960205 and his current mailing address is 2200 Park Ave, Burley, Idaho. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1952960205.

Contact Information

Tayne Peterson,
2200 Park Ave Ste 2,
Burley, ID 83318-2186
(208) 878-6684
(208) 678-3170



Healthcare Provider's Profile

Full NameTayne Peterson
GenderMale
SpecialityDentist - General Practice
Location2200 Park Ave Ste 2, Burley, Idaho
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1952960205
  • Provider Enumeration Date: 06/11/2019
  • Last Update Date: 09/07/2022

Medical Identifiers

Medical identifiers for Tayne Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1952960205NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223G0001XDentist - General Practice D-5401 (Idaho)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tayne Peterson is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Tayne Peterson,
2200 Park Ave,
Burley, ID 83318-2186

Ph: (208) 878-6684
Tayne Peterson,
2200 Park Ave Ste 2,
Burley, ID 83318-2186

Ph: (208) 878-6684

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Dentist in Burley, ID

Dr. Michael Bryson Stucki, DDS
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 1706 Overland Ave, Burley, ID 83318
Phone: 208-678-2332    
Dr. Kevin D. Banner, D.D.S.
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 1010 E Main St, Burley, ID 83318
Phone: 208-678-5597    Fax: 208-678-5663
Randal Todd Wilson, DMD
Dentist
Medicare: Medicare Enrolled
Practice Location: 1309 Bennett Ave, Burley, ID 83318
Phone: 208-677-5198    
Dr. Steve Paul Garn, D.D.S.
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 2200 Park Ave, Suite 2, Burley, ID 83318
Phone: 208-678-8188    Fax: 208-678-3170
Wayne Jack Wright, D.D.S.
Dentist
Medicare: Medicare Enrolled
Practice Location: 2200 Park Ave, Burley, ID 83318
Phone: 208-678-1478    
Logan Kay, DMD
Dentist
Medicare: Medicare Enrolled
Practice Location: 1309 Bennett Ave, Burley, ID 83318
Phone: 208-732-7447    
Dr. Justin Ward, D.M.D.
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 2271 Overland Ave, Suite 4, Burley, ID 83318
Phone: 208-678-3265    

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