DR. LEON ROBERT PECK DDS PH.D. NPI 1538185376

NPI Information

NPI: 1538185376
Provider Name: DR. LEON ROBERT PECK, DDS, PH.D.
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

PECOS Registration: Yes

Address:
8500 WILSHIRE BLVD
SUITE 815
BEVERLY HILLS, CA
ZIP 90211
Phone: (310) 657-6363
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DR. Leon Robert Peck, DDS, PH.D. is an oral and maxillofacial surgery dentist in Beverly Hills, CA with 52 years of experience. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. Leon Robert Peck, DDS, PH.D. NPI is 1538185376. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8500 WILSHIRE BLVD
SUITE 815
BEVERLY HILLS, CA
ZIP 90211-121
Phone: (310) 657-6363
Fax: (310) 652-5785

The NPI 1538185376 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/14/2006 and was last updated on 11/20/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	204E00000X	Oral & Maxillofacial Surgery		38348	CALIFORNIA	No
2	1223S0112X	Dentist	Oral and Maxillofacial Surgery	38348	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	U54089	MEDICARE UPIN	CALIFORNIA
2	B38348-01	MEDICAID	CALIFORNIA
3	D38348	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	MEDICARE PROVIDER #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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