Jason Michael Peck, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28995 Issued in TX

Practice address

4518 Center St
Deer Park, TX 77536-6351

Phone

(281) 479-2841

NPI assigned

May 30, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

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.

• Deer Park Family Dentistry

  • General Practice Dentistry
  • Deer Park, TX
  • NPI 1538557707
  NPD (past)
• Tregre & Associates DDS

  • Dentist
  • Deer Park, TX
  • NPI 1043407513
  NPD (past)

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1780021832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6222 FM 1374 RD",
            "city": "NEW WAVERLY",
            "state": "TX",
            "postal_code": "773583930",
            "telephone_number": "936-203-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4518 CENTER ST",
            "city": "DEER PARK",
            "state": "TX",
            "postal_code": "775366351",
            "telephone_number": "281-479-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "JASON",
        "middle_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-30",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jojo Ortishejolomi Omaghomi, DDS
• Veronica Osornia
• Parks Chiropractic
• Kimberly Michelle Parks, DC
• Minal D Patel, D.P.T
• Orialys Peraza Marrero
• Andrea Lyn Peterson
• Pinnacle Health Facilities XXX LP
• Karen Dann Plunkett
• Michael John Potosky, FNP-BC

• General Practice Dentistry in Deer Park, TX
• Providers in Deer Park, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; 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.