Patricia Peck, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DD1672 Issued in NM

Practice address

1692 Hospital Dr BLDG B
Ste 102
Santa Fe, NM 87505-4754

Phone

(505) 989-9033

Fax

(505) 989-9347

NPI assigned

Jul 17, 2006

Last updated

Oct 10, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1760400998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1692 HOSPITAL DR BLDG B",
            "address_2": "STE 102",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054754",
            "telephone_number": "505-989-9033",
            "fax_number": "505-989-9347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1692 HOSPITAL DR BLDG B",
            "address_2": "STE 102",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054754",
            "telephone_number": "505-989-9033",
            "fax_number": "505-989-9347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NM",
            "license": "DD1672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL INS",
            "identifier": "85-0477522",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009630",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA INS",
            "identifier": "1320507",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alan L Pearlman, M.D.
• Gavin Pearlman
• Leslie Pearlman, PH.D.
• Lori D Pearson Kramer, CNM
• Meredith Carol Pearson
• Robert W Pederson, MD
• Anna G Pell
• Austin Peltier, AP
• Martha Pena-Nazario, LPN
• Michael Andrew Pena, LMSW

• Pediatric Dentistry in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Pediatric Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; 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.