Augustine Peng, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DEN2000195 Issued in DC

Practice address

3925 Minnesota Ave NE FL 1
Washington, DC 20019-2662

Phone

(202) 396-1444

NPI assigned

Jul 7, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1073246963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E ST SW APT 508",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200243265",
            "telephone_number": "917-498-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 MINNESOTA AVE NE FL 1",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200192662",
            "telephone_number": "202-396-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENG",
        "first_name": "AUGUSTINE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-09-15",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN2000195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roosevelt Pendleton III
• Silver Pendleton
• Traydacia Kiara Pendleton, CRNM, MSN
• David James Pendzick
• Allan W Peng, PA-C
• Giselle Peng
• Justin Peng, MD
• Shuhui Peng, LPC
• Tammy Peng, R.D.
• Xiaoqing Peng, MD, PHD

• Dentist in Washington, DC
• Providers in Washington, DC by specialty
• Dentist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.