Provider Demographics
NPI:1770871006
Name:PETERSON, JAIME LYNNE (DDS)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:LYNNE
Last Name:PETERSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JAIME
Other - Middle Name:LYNNE
Other - Last Name:CYPROWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 FAIRWINDS DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-4511
Mailing Address - Country:US
Mailing Address - Phone:412-897-9692
Mailing Address - Fax:
Practice Address - Street 1:38 ORANGE ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2341
Practice Address - Country:US
Practice Address - Phone:828-252-9351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC91821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice