Bailey Peckham, DDS
Individual provider Active NPI Dentist · Benkelman, NE
NPI 1306739743 · NPPES record last updated Jun 3, 2025
Key facts
- NPI
- 1306739743
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 8100 (NE)
- Practice address
- 718 Chief St
Benkelman, NE 69021-2500 - Phone
- (308) 423-2024
- NPI assigned
- Jun 3, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8100 | NE | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peckham Dental LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8100 | NE | Yes |
Addresses
Primary practice location
718 Chief St
Benkelman, NE 69021-2500
Mailing address
PO Box 664
Benkelman, NE 69021-0664
Phone (308) 423-2024
Other providers in Benkelman, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.