Provider Demographics
NPI:1053526277
Name:PEPPES DENTAL GROUP P.A.
Entity type:Organization
Organization Name:PEPPES DENTAL GROUP P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:PEPPES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-642-3939
Mailing Address - Street 1:11551 GRANADA LN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1454
Mailing Address - Country:US
Mailing Address - Phone:913-642-3939
Mailing Address - Fax:913-642-3508
Practice Address - Street 1:11551 GRANADA LN
Practice Address - Street 2:SUITE 200
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1454
Practice Address - Country:US
Practice Address - Phone:913-642-3939
Practice Address - Fax:913-642-3508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty