Individual provider Active NPI

Alan L Peet, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • San Antonio, TX
National Provider Identifier
1356317036
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DE00007233 Issued in WA
Practice address
19527 Battle Oak
San Antonio, TX 78258-3119
Phone
(210) 292-5215
Fax
(210) 292-7879
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DE00007233 WA Primary

Addresses

Primary practice location

19527 Battle Oak
San Antonio, TX 78258-3119

Mailing address

19527 Battle Oak
San Antonio, TX 78258-3119
Phone (210) 292-5215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060817000158 WA Practitioner - Oral SurgeryPractitioner - Plastic and Reconstructive SurgeryPractitioner - Maxillofacial Surgery 5395748107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery, Plastic and Reconstructive Surgery
Education
Washington University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

550 N 5TH Ave
Sequim, WA 98382-3079
Phone (360) 681-0900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Derek R. Nykiel DDS PC Oral and Maxillofacial Surgery Current Accepting new patients
Alan L. Peet DDS PLLC CurrentSince Jun 20, 2006 Accepting new patients

Locations

550 N 5th Ave
Sequim, WA 98382
Phone (360) 681-0900

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259712000000",
    "number": "1356317036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19527 BATTLE OAK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583119",
            "telephone_number": "210-292-5215",
            "fax_number": "210-292-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19527 BATTLE OAK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583119",
            "telephone_number": "210-292-5215",
            "fax_number": "210-292-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEET",
        "first_name": "ALAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2009-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE00007233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.