Brian Jay Peters, D.M.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

22023 Issued in TX

Practice address

12501 Hymeadow Dr Ste 1a
Austin, TX 78750-1831

Phone

(512) 682-5437

NPI assigned

Nov 2, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Austin Childrens Dentistry

  • Pediatric Dentistry
  • Austin, TX
  • NPI 1093729923
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257120000000",
    "number": "1063748614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 MILL ST",
            "city": "MAXWELL",
            "state": "TX",
            "postal_code": "786564363",
            "telephone_number": "646-660-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 HYMEADOW DR STE 1A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787501831",
            "telephone_number": "512-682-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "BRIAN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-02",
        "last_updated": "2009-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "22023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elijah Pesudas, LMT
• Peter a. Kangos, MD, PA
• Peter Broberg, MD and Associates, PA
• Molly Peter, PHD
• Glenda Jean Peters-DO, M.D.
• Brianne Lynn Peters
• Carol L Peters, MD
• Crystal Renee' Peters, DDS
• Edward John Peters, M.D.
• Jarrod A Peters, CRNA

• Orthodontics and Dentofacial Orthopedics Dentistry in Austin, TX
• Providers in Austin, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.