Individual provider Active NPI

Mary Elizabeth Peebles, DDS

  • General Practice Dentistry
  • Broomfield, CO
National Provider Identifier
1992811939
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
104627 Issued in CO
Practice address
899 US Highway 287 Ste 600
Broomfield, CO 80020-7319
Phone
(303) 460-9366
Fax
(303) 460-8056
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 104627 CO Primary

Addresses

Primary practice location

899 US Highway 287 Ste 600
Broomfield, CO 80020-7319

Mailing address

899 US Highway 287 Ste 600
Broomfield, CO 80020-7319
Phone (303) 460-9366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20150407001868 CO Order and Referring Only - DentistPractitioner - Dentist 3173841996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104627COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Broomfield Premier Dentistry, PC PastSince Mar 24, 2024 Accepting new patients
Mary Elizabeth Peebles-Turner, DDS, PC General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992811939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 US HIGHWAY 287 STE 600",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800207319",
            "telephone_number": "303-460-9366",
            "fax_number": "303-460-8056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 US HIGHWAY 287 STE 600",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800207319",
            "telephone_number": "303-460-9366",
            "fax_number": "303-460-8056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEEBLES",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "104627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.