Individual provider Active NPI

Jazmin Julia Zelaya-Peo, DDS

  • General Practice Dentistry
  • Cotati, CA
National Provider Identifier
1629290432
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42104 Issued in CA
Practice address
421 East Cotati Avenue
Cotati, CA 94931
Phone
(707) 664-1200
Fax
(707) 664-1206
NPI assigned
May 2, 2007
Last updated
Aug 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 42104 CA Primary

Addresses

Primary practice location

421 East Cotati Avenue
Cotati, CA 94931

Mailing address

421 East Cotati Avenue
Cotati, CA 94931
Phone (707) 664-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
42104CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Julia Jazmin Peo, D.D.S., Inc. General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1629290432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 EAST COTATI AVENUE",
            "city": "COTATI",
            "state": "CA",
            "postal_code": "94931",
            "telephone_number": "707-664-1200",
            "fax_number": "707-664-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 EAST COTATI AVENUE",
            "city": "COTATI",
            "state": "CA",
            "postal_code": "94931",
            "telephone_number": "707-664-1200",
            "fax_number": "707-664-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELAYA-PEO",
        "first_name": "JAZMIN",
        "middle_name": "JULIA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cotati, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.