Kim L Peters, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4053 Issued in AL

Practice address

792 North Dean Rd
Auburn, AL 36830

Phone

(334) 821-8755

Fax

(334) 821-9526

NPI assigned

Oct 23, 2006

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 AL

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

State licenses

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.

• Central Park Dental Care PC

  • Dentist
  • Auburn, AL
  • NPI 1114031135
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285717934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 NORTH DEAN RD",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "36830",
            "telephone_number": "334-821-8755",
            "fax_number": "334-821-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 NORTH DEAN RD",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "36830",
            "telephone_number": "334-821-8755",
            "fax_number": "334-821-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "KIM",
        "middle_name": "L",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Anne Pecot
• Gregory Peden, PHARM D.
• Pediatric Clinic LLC
• Pediatric Clinic LLC
• Alexander James Perkins
• Kailee Peterson, LPC
• Joseph Anthony Petrone
• Amy Phillips, LPC, NCC, BC-TMH
• James Jackson Phillips Jr., DMD
• July Phouangmanivanh

• General Practice Dentistry in Auburn, AL
• Providers in Auburn, AL by specialty
• General Practice Dentistry in Alabama

• 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.