NPIMap

Organization Active NPI

Phillip E Peck DDS Inc

  • General Practice Dentistry
  • Mission Hills, CA
National Provider Identifier
1356551337
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20432 Issued in CA
Legal business name
PHILLIP E PECK DDS INC
Practice address
10550 Sepulveda Blvd
Suite 115
Mission Hills, CA 91345-1934
Phone
(818) 361-8669
Fax
(818) 361-6684
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Phillip Edward Peck, DDS
Title
President
Phone
(818) 361-8669

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 20432 CA Primary

Addresses

Primary practice location

10550 Sepulveda Blvd
Suite 115
Mission Hills, CA 91345-1934

Mailing address

10550 Sepulveda Blvd
Suite 115
Mission Hills, CA 91345-1934
Phone (818) 361-8669

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356551337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10550 SEPULVEDA BLVD",
            "address_2": "SUITE 115",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451934",
            "telephone_number": "818-361-8669",
            "fax_number": "818-361-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10550 SEPULVEDA BLVD",
            "address_2": "SUITE 115",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451934",
            "telephone_number": "818-361-8669",
            "fax_number": "818-361-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP E PECK DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-361-8669",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "20432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Hills, CA

Sources for this page

  • 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.