Wade Peers DDS PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

98362987 Issued in UT

Legal business name

WADE PEERS DDS PC

Practice address

2750 Rasmussen Rd Ste 106
Park City, UT 84098-5401

Phone

(435) 615-9840

Fax

(435) 615-9842

NPI assigned

Feb 3, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Wade A Peers, D.D.S.

Title

Owner

Phone

(435) 615-9840

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1639401532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 RASMUSSEN RD STE 106",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985401",
            "telephone_number": "435-615-9840",
            "fax_number": "435-615-9842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 RASMUSSEN RD STE 106",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985401",
            "telephone_number": "435-615-9840",
            "fax_number": "435-615-9842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WADE PEERS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "PEERS",
        "authorized_official_first_name": "WADE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-615-9840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "98362987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000063649",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Park City, UT
• Providers in Park City, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; 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.