Cong Peng, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

34144 Issued in TX

Practice address

6821 Stewart Rd
Galveston, TX 77551-1841

Phone

(781) 627-6588

NPI assigned

Jun 15, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Icare Dental

  • Dental Clinic/Center
  • Missouri City, TX
  • NPI 1811622707
  Medicare reassignment NPD Authorized official
• Ilove Dental Studio, PLLC

  • Dental Clinic/Center
  • Houston, TX
  • NPI 1235062258
  NPD Authorized official

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1750875662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 COVE VIEW BLVD APT 3533",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775548175",
            "telephone_number": "781-627-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6821 STEWART RD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775511841",
            "telephone_number": "781-627-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENG",
        "first_name": "CONG",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-15",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34144",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "34144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "34144",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peaceful Tranquility Hospice II, Inc
• Pediatric Dental Care
• Pediatric Orthotic and Prosthetic Services-Southeast, LLC
• Dora Gonzalez Pedraza, FNP
• Craig Davidson Peiris, MD
• Beverly Gail Pennington, FNP
• Daniel Aubrey Penton, CRNA
• Heather Penton
• Wendi Lea Peralta, RN FNP-C
• Nidia Marcela Perez Herrera, MD

• Oral and Maxillofacial Surgery (Dentist) in Galveston, TX
• Providers in Galveston, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.