Active NPI
Peter Gary Mertz, DDS
- Dentist
- Longmont, CO
National Provider Identifier
1376544429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 108150
- Practice address
- 1325 Dry Creek Dr Ste 304
Longmont, CO 80503-7751 - Phone
- (303) 678-1111
- Fax
- (303) 678-5168
- NPI assigned
- Aug 10, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 108150 | CO | |
| Dentist | 122300000X | 108150 | CO | Primary |
Addresses
Primary practice location
1325 Dry Creek Dr Ste 304
Longmont, CO 80503-7751
Mailing address
1325 Dry Creek Dr Ste 304
Longmont, CO 80503-7751
Phone (303) 678-1111
Other practice location 1
1950 Terry St
Longmont, CO 80501-1835
Phone (303) 678-1111
Other names 1
- Dr. Peter Mertz
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141121001061 | TX | Order and Referring Only - Oral Surgery | 4082836366 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 108150 | CO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707436800000",
"number": "1376544429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 DRY CREEK DR STE 304",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805037751",
"telephone_number": "303-678-1111",
"fax_number": "303-678-5168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 DRY CREEK DR STE 304",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805037751",
"telephone_number": "303-678-1111",
"fax_number": "303-678-5168"
}
],
"practiceLocations": [
{
"address_1": "1950 Terry St",
"address_purpose": "LOCATION",
"city": "Longmont",
"state": "CO",
"postal_code": "805011835",
"country_code": "US",
"telephone_number": "303-678-1111",
"fax_number": "303-678-5168",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MERTZ",
"first_name": "PETER",
"middle_name": "GARY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-10",
"last_updated": "2024-02-09",
"certification_date": "2024-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "108150",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "108150",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "PETER",
"last_name": "MERTZ",
"prefix": "DR.",
"credential": "DDS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Longmont, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.