Peacock Dental Associates LTD

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PEACOCK DENTAL ASSOCIATES LTD

Practice address

320 N McLean Blvd
Elgin, IL 60123

Phone

(847) 697-2550

Fax

(847) 697-0308

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John Martin Peacock, DDS

Title

President

Phone

(847) 697-2550

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346315645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 N MCLEAN BLVD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60123",
            "telephone_number": "847-697-2550",
            "fax_number": "847-697-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N MCLEAN BLVD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60123",
            "telephone_number": "847-697-2550",
            "fax_number": "847-697-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACOCK DENTAL ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-697-2550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Patz
• Paul L. Engen DDS PC
• Dana Marie Pauley
• Melissa Pazen, MSW
• Alevtina Pchelova
• Pearl of Elgin, LLC
• Shelly A. Pearson, P.T.
• Jasmine Pease
• Farrah Pece
• Joshua R Peck, M.S.

• Dentist in Elgin, IL
• Providers in Elgin, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.