Peter Summerfelt, D.M.D.
Individual provider Active NPI General Practice Dentistry · Zuni, NM
NPI 1184918906 · NPPES record last updated Oct 29, 2013
Key facts
- NPI
- 1184918906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DS038517 (PA)
- Practice address
- 301 N. B St.
Zuni, NM 87327 - Phone
- (617) 686-7085
- NPI assigned
- Jun 9, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS038517 | PA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS038517 | PA | Yes |
Addresses
Primary practice location
301 N. B St.
Zuni, NM 87327
Mailing address
PO Box 542
Zuni, NM 87327-0542
Phone (617) 686-7085
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 68221231 | Medicaid | NM |
Other providers in Zuni, NM
- Jaimie Paulene Schwendner
- Shannon K Slinkey
- Julia E Soap
- Kimberly Aisha Stanfield
- Cody Gene Stevenson
- Rachel Leftwich Trippett
- Laura Urbanski
- Joy Della McQuery Vala
- Robert K. Waatsa
- John David Walker
All providers in Zuni, NM · General Practice Dentistry in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.