Tim G Peffly DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

28373 Issued in CA

Legal business name

TIM G PEFFLY DDS INC

Practice address

615 North I Street
Madera, CA 93637

Phone

(559) 673-8044

Fax

(559) 673-5447

NPI assigned

Feb 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Tim G Peffly, DENTIST DDS

Title

President

Phone

(559) 673-8044

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349136000000",
    "number": "1235271883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 NORTH I STREET",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "93637",
            "telephone_number": "559-673-8044",
            "fax_number": "559-673-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 NORTH I STREET",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "93637",
            "telephone_number": "559-673-8044",
            "fax_number": "559-673-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIM G PEFFLY DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2012-10-02",
        "status": "A",
        "authorized_official_last_name": "PEFFLY",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-673-8044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DENTIST DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "28373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "B2837301",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Madera, CA
• Providers in Madera, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; 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.