NPIMap

Organization Active NPI

James Peck DDS PLLC

  • Dentist
  • Edmond, OK
National Provider Identifier
1164720520
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6111 Issued in OK
Legal business name
JAMES PECK DDS PLLC
Practice address
18001 N Western Ave Ste 106
Edmond, OK 73012
Phone
(405) 562-9550
NPI assigned
Mar 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Authorized official

Name
Dr. James Calvin Peck Jr., DDSNPI 1730317546
Title
President
Phone
(405) 562-9550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6111 OK Primary

Addresses

Primary practice location

18001 N Western Ave Ste 106
Edmond, OK 73012

Mailing address

18001 N Western Ave Ste 106
Edmond, OK 73012
Phone (405) 562-9550

Other names 1

  • Redbud Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560816000000",
    "number": "1164720520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18001 N WESTERN AVE STE 106",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73012",
            "telephone_number": "405-562-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18001 N WESTERN AVE STE 106",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73012",
            "telephone_number": "405-562-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES PECK DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-09",
        "last_updated": "2019-06-18",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CALVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-562-9550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "6111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redbud Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Redbud Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.