William T Peck, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019027013 Issued in IL

Practice address

1507 N Veterans Pkwy
Suite 2
Bloomington, IL 61704-0904

Phone

(309) 664-5033

Fax

(309) 663-0967

NPI assigned

Mar 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Plainfield Dental Practice Inc

  • Dental Clinic/Center
  • Plainfield, IL
  • NPI 1619680311
  NPD Authorized official
• Affordable Dentistry Today, PC

  • General Practice Dentistry
  • Bloomington, IL
  • NPI 1205058666
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235268756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 N VETERANS PKWY",
            "address_2": "SUITE 2",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617040904",
            "telephone_number": "309-664-5033",
            "fax_number": "309-663-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 N VETERANS PKWY",
            "address_2": "SUITE 2",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617040904",
            "telephone_number": "309-664-5033",
            "fax_number": "309-663-0967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "WILLIAM",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Pawley, LAC
• Paxcia Counseling Services PLLC
• Kaitlyn Payne
• Lange K Payne, LPC, LMFTA
• Taylor Pease
• Anthony Pecora Pecora, D.D.S.,M.S.
• Paul Pedersen
• Pediatric Dental Associates of McLean County, Inc
• Michael Robert Peffer, DC
• Edward W Pegg III, MD

• Dentist in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.