Active NPI
Peter Edward Strock, DDS
- General Practice Dentistry
- Vineyard Haven, MA
National Provider Identifier
1063419182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9902
- Practice address
- 93 Main St
Vineyard Haven, MA 02568-5402 - Phone
- (508) 693-1319
- Fax
- (508) 693-4692
- NPI assigned
- Jul 5, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9902 | MA | Primary |
Addresses
Primary practice location
93 Main St
Vineyard Haven, MA 02568-5402
Mailing address
PO Box 1718
93 Main Street
Vineyard Haven, MA 02568-0909
Phone (508) 693-1319
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 |
|---|---|---|---|
| 9902 | MA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1063419182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1718",
"address_2": "93 MAIN STREET",
"city": "VINEYARD HAVEN",
"state": "MA",
"postal_code": "025680909",
"telephone_number": "508-693-1319",
"fax_number": "508-693-4692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "93 MAIN ST",
"city": "VINEYARD HAVEN",
"state": "MA",
"postal_code": "025685402",
"telephone_number": "508-693-1319",
"fax_number": "508-693-4692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STROCK",
"first_name": "PETER",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-05",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "9902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vineyard Haven, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.