Active NPI
Peter Frederick Heitman, DMD
- Dentist
- Fort Sill, OK
National Provider Identifier
1760037758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9383
- Practice address
- USA Dental Activity
652 Hamilton Rd.
Fort Sill, OK 73503 - Phone
- (580) 442-5488
- NPI assigned
- Aug 6, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9383 | SC | Primary |
Addresses
Primary practice location
USA Dental Activity
652 Hamilton Rd.
Fort Sill, OK 73503
Mailing address
CDR US Army Dental Activity
2441 21St Street
Fort Campbell, TN 37040
Phone (270) 798-8977
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9383 | SC | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595808000000",
"number": "1760037758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CDR US ARMY DENTAL ACTIVITY",
"address_2": "2441 21ST STREET",
"city": "FORT CAMPBELL",
"state": "TN",
"postal_code": "37040",
"telephone_number": "270-798-8977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "USA DENTAL ACTIVITY",
"address_2": "652 HAMILTON RD.",
"city": "FORT SILL",
"state": "OK",
"postal_code": "73503",
"telephone_number": "580-442-5488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEITMAN",
"first_name": "PETER",
"middle_name": "FREDERICK",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-06",
"last_updated": "2020-07-27",
"certification_date": "2020-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "9383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Sill, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.