Individual provider Active NPI

George A. Peeples, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • El Monte, CA
National Provider Identifier
1619196235
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
027913 Issued in CA
Practice address
3113 Santa Anita Ave
El Monte, CA 91780
Phone
(626) 444-2605
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 027913 CA Primary

Addresses

Primary practice location

3113 Santa Anita Ave
El Monte, CA 91780

Mailing address

1032 Loma Lisa LN
Arcadia, CA 91006-2218
Phone (626) 824-0073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20161014001163 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7719275320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
027913CAMDOral and Maxillofacial Pathology Dentist

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619196235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 LOMA LISA LN",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910062218",
            "telephone_number": "626-824-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 SANTA ANITA AVE",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "91780",
            "telephone_number": "626-444-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEEPLES",
        "first_name": "GEORGE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "CA",
            "license": "027913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

Verify at the official NPI Registry.