DR. DAREN LANDIS PEACE DMD NPI 1619040995

NPI Information

NPI: 1619040995
Provider Name: DR. DAREN LANDIS PEACE, DMD
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

PECOS Registration: Yes

Address:
9709 DIXIE HWY
LOUISVILLE, KY
ZIP 40272
Phone: (502) 933-7363
Get Directions

DR. Daren Landis Peace, DMD is a pediatric dentistry dentist in Louisville, KY. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Daren Landis Peace, DMD NPI is 1619040995. 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:

9709 DIXIE HWY
LOUISVILLE, KY
ZIP 40272-939
Phone: (502) 933-7363
Fax: (502) 805-1957

The NPI 1619040995 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).

The enumeration date for this NPI number is 11/16/2006 and was last updated on 8/23/2013.

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	1223G0001X	Dentist	General Practice	KY8102	KENTUCKY	No
2	122300000X	Dentist		8102	KENTUCKY	No
3	1223P0221X	Dentist	Pediatric Dentistry	8102	KENTUCKY	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	7100137020	MEDICAID	KENTUCKY

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

NPI Synchronization or Removal

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