Individual provider Active NPI

Peter Gerard Garcia, DDS

  • General Practice Dentistry
  • Mesa, AZ
National Provider Identifier
1336350529
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D4223 Issued in AZ
Practice address
1722 E University Dr
Mesa, AZ 85203-8210
Phone
(480) 833-9942
NPI assigned
May 27, 2007
Last updated
Jan 7, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D4223 AZ Primary

Addresses

Primary practice location

1722 E University Dr
Mesa, AZ 85203-8210

Mailing address

2712 E Virginia St
Gilbert, AZ 85296-8998
Phone (480) 284-3881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20231215002684 AZ Practitioner - Oral SurgeryPractitioner - Dentist 7911210570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D4223AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ray Road Dmso LLC CurrentSince Nov 4, 2023 Accepting new patients
Tru-Value Denture and Dental Center Past Accepting new patients
Crismon Road Dmso LLC PastSince Jul 24, 2022 Accepting new patients

Locations

2900 W Ray Rd
Ste 3
Chandler, AZ 85224
Phone (480) 393-0687

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1180224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389052800000",
    "number": "1336350529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 E VIRGINIA ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852968998",
            "telephone_number": "480-284-3881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 E UNIVERSITY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852038210",
            "telephone_number": "480-833-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "PETER",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-27",
        "last_updated": "2014-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D4223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.