NPIMap

Organization Active NPI

Exindent

Doing business as Peter Emmons

  • Dentist
  • Ketchikan, AK
National Provider Identifier
1639534696
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
105109 Issued in AK
Legal business name
EXINDENT
Doing business as
Peter Emmons
Practice address
130 Carlanna Lake Rd
Ketchikan, AK 99901-5669
Phone
(832) 726-6655
NPI assigned
Dec 17, 2015
Last updated
Dec 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Authorized official

Name
Dr. Peter Adams Emmons, DDS
Title
Dentist
Phone
(832) 726-6655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 105109 AK Primary

Addresses

Primary practice location

130 Carlanna Lake Rd
Ketchikan, AK 99901-5669

Mailing address

1342 N 650 E
Tooele, UT 84074-9848
Phone (832) 726-6655

Other names 1

  • Peter Emmons Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450310400000",
    "number": "1639534696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1342 N 650 E",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840749848",
            "telephone_number": "832-726-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CARLANNA LAKE RD",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015669",
            "telephone_number": "832-726-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXINDENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A",
        "authorized_official_last_name": "EMMONS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "ADAMS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "832-726-6655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AK",
            "license": "105109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peter Emmons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ketchikan, AK

Sources for this page

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