Robert Peak, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

16382 Issued in TX

Practice address

900 Jerome St
Suite 140
Fort Worth, TX 76104-3945

Phone

(817) 522-1833

NPI assigned

Apr 12, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 12, 2024 through Jul 12, 2028

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: rpeak87126@cookchildrens.direct-ci.com

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1235353301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 JEROME ST",
            "address_2": "SUITE 140",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043945",
            "telephone_number": "817-522-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 JEROME ST",
            "address_2": "SUITE 140",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043945",
            "telephone_number": "817-522-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEAK",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "16382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TX",
            "identifier": "85D054",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peak Physical Medicine and Wellness PLLC
• Peak Physical Therapy, LLC
• Peak Physical Therapy, LLC
• Peak Physical Therapy, LLC
• Natalee Peak
• Chantel N Pearce, RN
• Pearl Smile Dental PLLC
• Adam Pearl, MD
• Pearlz Eye Care, PLLC
• Andrew Jay Pearson, PA-C

• Oral and Maxillofacial Surgery (Dentist) in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.