Active NPI
Nicole Peace
- Dentist
- Glenshaw, PA
National Provider Identifier
1164045852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DSO42673
- Practice address
- 1509 Mount Royal Blvd
Glenshaw, PA 15116-2207 - Phone
- (412) 486-5155
- NPI assigned
- May 28, 2020
- Sex
- Female
- 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 | DSO42673 | PA | Primary |
Addresses
Primary practice location
1509 Mount Royal Blvd
Glenshaw, PA 15116-2207
Mailing address
1509 Mount Royal Blvd
Glenshaw, PA 15116-2207
Phone (412) 486-5155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200825003493 | PA | Order and Referring Only - Dentist | 1951728658 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DSO42673 | PA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peace Dental Associates | Current | Accepting new patients | |
| Peace Dental, PC | Past | Accepting new patients |
Locations
1509 Mount Royal Blvd
Glenshaw, PA 15116
Phone (412) 486-5155
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Clarion, PA
- NPI 1447874490
-
- General Practice Dentistry
- Glenshaw, PA
- NPI 1013093640
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590624000000",
"number": "1164045852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1509 MOUNT ROYAL BLVD",
"city": "GLENSHAW",
"state": "PA",
"postal_code": "151162207",
"telephone_number": "412-486-5155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1509 MOUNT ROYAL BLVD",
"city": "GLENSHAW",
"state": "PA",
"postal_code": "151162207",
"telephone_number": "412-486-5155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEACE",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-28",
"last_updated": "2020-05-28",
"certification_date": "2020-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DSO42673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenshaw, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.