NPIMap

Individual provider Active NPI

Dwight Daniel Peccora, D.D.S.

  • Dentist
  • Missouri City, TX
National Provider Identifier
1124330782
Registry record updated Jul 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0025645 Issued in TX
Practice address
5819 Highway 6 Ste 230
Missouri City, TX 77459-4070
Phone
(281) 499-3541
NPI assigned
Jul 11, 2010
Last updated
Jul 11, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0025645 TX Primary

Addresses

Primary practice location

5819 Highway 6 Ste 230
Missouri City, TX 77459-4070

Mailing address

5819 Highway 6 Ste 230
Missouri City, TX 77459-4070
Phone (281) 499-3541

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

LicenseStateTypeSpecialty
0025645TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Bend Dental Grand Parkway, PLLC Current Accepting new patients
Fort Bend Dental Sleep Medicine, PLLC Current Accepting new patients

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1278806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278806400000",
    "number": "1124330782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5819 HIGHWAY 6 STE 230",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594070",
            "telephone_number": "281-499-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5819 HIGHWAY 6 STE 230",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594070",
            "telephone_number": "281-499-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECCORA",
        "first_name": "DWIGHT",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-11",
        "last_updated": "2010-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "0025645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2010; 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.