Jeffrey David Peter, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8860 Issued in KY

Practice address

2025 Declaration Dr Ste B
Independence, KY 41051-7983

Phone

(859) 429-1327

NPI assigned

Aug 20, 2010

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

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 16, 2015 through Jun 16, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Peter Family Dentistry LLC

  • General Practice Dentistry
  • Independence, KY
  • NPI 1194429738
  NPD Authorized official

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1609182286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 DECLARATION DR STE B",
            "city": "INDEPENDENCE",
            "state": "KY",
            "postal_code": "410517983",
            "telephone_number": "859-429-1327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 DECLARATION DR STE B",
            "city": "INDEPENDENCE",
            "state": "KY",
            "postal_code": "410517983",
            "telephone_number": "859-429-1327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETER",
        "first_name": "JEFFREY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-20",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Edward Parrott
• Linda Catherine Payne, M.A.
• Cheyenne Nicole Peace, CNA
• Craig S Pennell, OD
• Peter Family Dentistry LLC
• Donna L Pleiman, MD
• Kelvin Poore
• Poppy Path Counseling, LLC
• Ryan Porter
• Danielle Bielata Powrie, OTR/L

• General Practice Dentistry in Independence, KY
• Providers in Independence, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.

Verify at the official NPI Registry.