Kelly Kristina Peaks, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8986 Issued in TN

Practice address

2305 Rudolphtown Rd
Clarksville, TN 37043-2228

Phone

(931) 645-6362

NPI assigned

May 21, 2009

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Richard C. Ribeiro

  • Dental Clinic/Center
  • Clarksville, TN
  • NPI 1457550006
  NPD (past)
• Best Rest Virginia

  • General Practice Dentistry
  • Ashburn, VA
  • NPI 1689401176
  NPD (past)
• First Impression Dental PLLC

  • General Practice Dentistry
  • Ashburn, VA
  • NPI 1184069247
  NPD (past)

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

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245283200000",
    "number": "1457586331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 RUDOLPHTOWN RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370432228",
            "telephone_number": "931-645-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 RUDOLPHTOWN RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370432228",
            "telephone_number": "931-645-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEAKS",
        "first_name": "KELLY",
        "middle_name": "KRISTINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2009-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "8986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terry G Peacher, MD
• Peachers Mill Dental
• Vanessa Peacock, RN
• Peak Performance Health Clinic, PLLC
• Alycia Marsili Peake, DC
• Samantha Pearsall, DPT
• Carrie Anne Pearson, M.ED, ATC
• Eelece Lasalle Pearson, RN
• Harleigh Ann Pearson
• Jessica Pearson, SLP-CCC

• General Practice Dentistry in Clarksville, TN
• Providers in Clarksville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.