Cody John Percival, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DENT.DE.70015681 Issued in WA

Practice address

340 Boatner Rd BLDG 2751
Eglin Afb, FL 32542-1391

Phone

(850) 883-8324

NPI assigned

Nov 27, 2023

Sex

Male

Sole proprietor

No

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

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": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1821864497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 BOATNER RD BLDG 2751",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BOATNER RD BLDG 2751",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421391",
            "telephone_number": "850-883-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERCIVAL",
        "first_name": "CODY",
        "middle_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-27",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DENT.DE.70015681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurence L. Pass, PSY.D.
• Benjamin Patrick, PMHNP
• Paul L Pearman Jr., PT, DPT, OCS
• Daniel Pehrson
• Melissa Leigh Penny, DO
• Lizbeth Lorena Perez Rodriguez, MD
• Elizabeth Perryman, PHD, LCSW, BCD
• Lucas Ryan Petkewitz, DPT
• Michelle Renee Pettit, LCSW
• Lainey Medine Petty, PA-C

• Dentist in Eglin Afb, FL
• Providers in Eglin Afb, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.