Daren Landis Peace, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

8102 Issued in KY

Practice address

9709 Dixie Hwy
Louisville, KY 40272-3939

Phone

(502) 933-7363

Fax

(502) 805-1957

NPI assigned

Nov 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

State licenses

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1619040995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9709 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402723939",
            "telephone_number": "502-933-7363",
            "fax_number": "502-805-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9709 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402723939",
            "telephone_number": "502-933-7363",
            "fax_number": "502-805-1957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACE",
        "first_name": "DAREN",
        "middle_name": "LANDIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "KY8102",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "8102",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "8102",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100137020",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• PDS Consultants Inc
• PDS Consultants Optical LLC
• PDS Consultants Optical LLC
• Kimberly Karp Peabody, LCSW
• Peace of Mind Psychiatry, PLLC
• Peaceful Solutions Counseling Inc
• Peacemaker Eldercare
• Peach Medical
• Amanda D Peach, APRN
• Nicholas Richard Peairs

• Pediatric Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• Pediatric Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; 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.