Slade DMD Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

58800 Issued in CA

Legal business name

SLADE DMD CORPORATION

Doing business as

Peach Tree Dental

Practice address

862 Meinecke Avenue
Suite 200
San Luis Obispo, CA 93405

Phone

(805) 544-7804

Fax

(805) 544-6020

NPI assigned

Apr 13, 2007

Last updated

Aug 4, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Troy Kendall Slade, D.M.D.

Title

Dentist/Owner

Phone

(805) 544-7804

Specialties & licenses 2

Addresses

Other names 1

• Peach Tree Dental Doing business as

Locations

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407110400000",
    "number": "1750506036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "862 MEINECKE AVENUE",
            "address_2": "SUITE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93405",
            "telephone_number": "805-544-7804",
            "fax_number": "805-544-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 MEINECKE AVENUE",
            "address_2": "SUITE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93405",
            "telephone_number": "805-544-7804",
            "fax_number": "805-544-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLADE DMD CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2014-08-04",
        "status": "A",
        "authorized_official_last_name": "SLADE",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "KENDALL",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "805-544-7804",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "62898",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peach Tree Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Armando F Siqueiros, MD
• Laura Skaarup
• Carinn Skarry
• Jessica Skeels-Hansen, PT
• Keith D Skromme
• Brandon James Slade, DPM
• Clinton Andrew Slaughter, M.D.
• Laura Dawn Slaughter, RN, FNP-C
• Elisabeth Sledz, MD
• Sleeptech, LLC (Coastal Sleep Disorders Center)

• General Practice Dentistry in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.