Active NPI
Stanley Eugene Peay, DDS
- General Practice Dentistry
- Bountiful, UT
National Provider Identifier
1386808491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 130504
- Practice address
- 246 N Main St
Bountiful, UT 84010-6136 - Phone
- (801) 295-5131
- NPI assigned
- Jul 17, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 130504 | UT | Primary |
Addresses
Primary practice location
246 N Main St
Bountiful, UT 84010-6136
Mailing address
246 N Main St
Bountiful, UT 84010-6136
Phone (801) 295-5131
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 7, 2014 through May 7, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 130504 | UT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216252800000",
"number": "1386808491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "246 N MAIN ST",
"city": "BOUNTIFUL",
"state": "UT",
"postal_code": "840106136",
"telephone_number": "801-295-5131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "246 N MAIN ST",
"city": "BOUNTIFUL",
"state": "UT",
"postal_code": "840106136",
"telephone_number": "801-295-5131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEAY",
"first_name": "STANLEY",
"middle_name": "EUGENE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-17",
"last_updated": "2008-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "UT",
"license": "130504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bountiful, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.