Peter W. Doerken, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

21874 Issued in CA

Practice address

1448 15TH Street
Suite 100
Santa Monica, CA 90404

Phone

(310) 458-9800

Fax

(310) 458-9891

NPI assigned

Dec 27, 2012

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1356687057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 15TH STREET",
            "address_2": "SUITE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90404",
            "telephone_number": "310-458-9800",
            "fax_number": "310-458-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 15TH STREET",
            "address_2": "SUITE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90404",
            "telephone_number": "310-458-9800",
            "fax_number": "310-458-9891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOERKEN",
        "first_name": "PETER",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-27",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "21874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Doan, NP
• Charles Richard Dobeck, D.D.S.
• Sharon Heller Dobeck, RDH
• Doctor TLC, License Clinical Psychologist, Inc.
• Doctors and Nurses to the World Foundation
• Eric Jay Dolgin, D.O.
• Dmitry Vladimir Dolgov, DMD
• Lauren Anne Dolinsky, LMFT
• Margaret Louise Dominguez, PH.D.
• Dana Marie Donahoe, AMFT

• Dentist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.