DR. JASON DAYNE PETERSEN MD NPI 1215105804

NPI Information

  • NPI: 1215105804
  • Provider Name: DR. JASON DAYNE PETERSEN, MD
  • Classification: Plastic Surgery - 2082S0099X
  • Specialization: Plastic Surgery Within the Head and Neck
  • Entity Type: Individual
  • Address: 5353 S 960 E
    #150
    SALT LAKE CITY, UT
    ZIP 84117
  • Phone: (801) 261-5791

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NPI Details

DR. Jason Dayne Petersen, MD is a plastic surgery within the head and neck plastic surgery in Salt Lake City, UT. The provider is a plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them. DR. Jason Dayne Petersen, MD NPI is 1215105804. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5353 S 960 E
#150
SALT LAKE CITY, UT
ZIP 84117-569
Phone: (801) 261-5791
Fax: (801) 747-7740

The enumeration date for this NPI number is 2/15/2008 and was last updated on 8/7/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208200000XPlastic Surgery83185641205UTAHNo
22082S0099XPlastic SurgeryPlastic Surgery Within the Head and Neck83185641205UTAHYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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