Active NPI
Daniel Granger Peck
- Dentist
- Poulsbo, WA
National Provider Identifier
1003007030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE00010941
- Practice address
- 20855 Bond Rd NE
Poulsbo, WA 98370-9014 - Phone
- (360) 779-5546
- NPI assigned
- Aug 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE00010941 | WA | Primary |
Addresses
Primary practice location
20855 Bond Rd NE
Poulsbo, WA 98370-9014
Mailing address
20855 Bond Rd NE
Poulsbo, WA 98370-9014
Phone (360) 779-5546
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00010941 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186358400000",
"number": "1003007030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20855 BOND RD NE",
"city": "POULSBO",
"state": "WA",
"postal_code": "983709014",
"telephone_number": "360-779-5546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20855 BOND RD NE",
"city": "POULSBO",
"state": "WA",
"postal_code": "983709014",
"telephone_number": "360-779-5546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "DANIEL",
"middle_name": "GRANGER",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-06",
"last_updated": "2007-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE00010941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poulsbo, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.