Dr. Samuel Petersen , DMD
Dentist - General Practice β’ Eagle, ID
450 W State St Ste 115
Eagle, ID 836167055
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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Dr. Samuel Petersen is listed in NPPES under Dentist - General Practice.
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NPI assigned on June 10, 2018; this date does not establish years in practice.
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Published CMS data list 16 Medicare Part D prescriptions, including refills, in 2021.
Source: CMS, Medicare Part D Prescribers β by Provider and Drug, 2021. Published rows only; this is not a quality measure.
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Published Part D records, 2021:
- Amoxicillin β 16 prescription fills, including refills.
Source: CMS, Medicare Part D Prescribers β by Provider and Drug, 2021. Drug names come from pharmacy claims. Listing a drug here is not an endorsement or a recommendation.
See the full table Β· Guide: How to read Medicare Part D prescriber data
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Medicare Part D prescriptions went from 14 in 2020 to 16 in 2021.
Source: CMS, Medicare Part D Prescribers β by Provider and Drug, 2020β2021.
Practice Location & Contact Primary Location
450 W State St Ste 115
Eagle, ID 836167055
NPPES lists 1 additional practice-address record in Meridian, ID. See the list
Source: CMS NPPES NPI Registry, practice location records; release date unavailable.
Listings do not confirm current availability, employment or a shared ownership network.
What Public CMS Data Show
Dentist - General Practice: NPPES taxonomy is a reported classification, not proof of board certification.
30-day fills
16 standardized 30-day fills in 2021
CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.
What this does not show: 30-day fills
It is not a count of patients and not a measure of quality.
Part D drug cost
$62 in 2021
The total cost of these prescriptions in 2021, paid by Medicare drug plans, patients and other payers together.
It shows the total spending on drugs this clinician prescribed, not what any one patient paid.
What this does not show: Part D drug cost
A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.
Source: CMS, Medicare Part D Prescribers β by Provider and Drug, 2021.
Open Payments general payments, program year 2023
All general payments: $29.18 across 2 records.
By nature of payment
- Food and Beverage: $29.18 across 2 records.
Reporting-company totals
- STERIS CORPORATION: $15.85 across 1 record.
- Philips Electronics North America Corporation: $13.33 across 1 record.
A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.
Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2023 (published June 30, 2026).
NPI first issued
2018
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, βDoes your provider accept Medicare as full payment?β
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Compared with the same specialty in Eagle and Idaho
Billing and prescribing volume is not a quality rating.
Medicare Part D
Comparisons use 2024 data. The latest CMS data for Dr. Petersen are from 2021.
16 active clinicians are listed under Dentist - General Practice with a practice address in Eagle, ID (755 in Idaho).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Eagle
0% of these 16 clinicians have the CMS telehealth indicator.
0% of these 16 clinicians are listed by CMS as accepting Medicare assignment.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part D prescriptions
Medicare Part D prescriptions went from 14 in 2020 to 16 in 2021.
- 2020: 14
- 2021: 16
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30-day fills
30-day fills went from 14 in 2020 to 16 in 2021.
- 2020: 14
- 2021: 16
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Part D drug cost
Part D drug cost went from $72 in 2020 to $62 in 2021.
- 2020: $72
- 2021: $62
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Industry payments (Open Payments)
CMS data for industry payments (Open Payments) are available for 2023 only.
Sources: CMS Medicare Part D Prescribers (2021), CMS Open Payments (2023), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo Β· Report an error.
Pharma & Medical Device Financial Disclosures
Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments
Program year 2023 (payments made January 1 β December 31, 2023): fewer than 11 records totaling $29.18.
| Manufacturer | Payment Nature | Product | Type | Amount ($) |
|---|---|---|---|---|
| STERIS CORPORATION |
Food and Beverage
In-kind items and services
|
β | General | $15.85 |
| Philips Electronics North America Corporation |
Food and Beverage
Cash or cash equivalent
|
(0363) HighFlexc Handles | General | $13.33 |
Source: CMS Open Payments, program year 2023, released June 30, 2026.
Medicare Part D Prescribing Profile & Medications
Medicare Part D prescriptions filled, including refills, in 2021.
| Brand Name | Generic Name | Prescriptions | Day Supply | Total Cost | Patients |
|---|---|---|---|---|---|
| Amoxicillin | Amoxicillin | 16 | 127 | $62.44 | 12 |
Source: CMS Part D by Provider and Drug, 2021; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2024-02-07NUCC Taxonomy Code: 1223G0001X
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
NUCC Taxonomy Code: 122300000X
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Secondary Practice Locations
6700 N Linder Rd Ste 132
Meridian, ID 83646
Phone: 2086399480
6700 N Linder Rd Ste 132
Meridian, ID 83646
Phone: 2086399480
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Registered at 450 W STATE ST STE 115, EAGLE, ID 836167055 (Tel: 2083705203)
Registered at 450 W STATE ST STE 115, EAGLE, ID 836167055 (Tel: 2083705203)
Registered at 6700 N LINDER RD STE 132, MERIDIAN, ID 83646 (Tel: 2086399480)
Registered at 5066 N ABERDEEN PL, MERIDIAN, ID 836465603 (Tel: 2082404649)
Recorded as SAMUEL PETERSEN, DMD
NPI status registered as active in NPPES database
Registered at 3701 HOPEWELL RD, LOUISVILLE, KY 402995392 (Tel: 5022665661)
Registered at 1910 WESTMOORLAND WAY, LOUISVILLE, KY 402423447 (Tel: 2082404649)
Recorded as SAMUEL PETERSEN
Dentist (license number reported to NPPES: KY 10136)
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Other Dentist - General Practices in Eagle
- Dr. Michael Higginson, DDS
- Dr. Josh Crank, DMD
- Dr. Donald Larson, DMD
- Dr. Andrew Baird, DDS, PLLC
- Dr. Ashley Sara, DMD
- Dr. Christopher Thomason, DMD
Mailing Address
450 W State St Ste 115
Eagle, ID 836167055
Phone: 2083705203