Healthcare Provider Details

I. General information

NPI: 1528757135
Provider Name (Legal Business Name): KAISI PEELE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MILL END CT STE A
ELIZABETH CITY NC
27909-8987
US

IV. Provider business mailing address

101 MILL END CT STE A
ELIZABETH CITY NC
27909-8987
US

V. Phone/Fax

Practice location:
  • Phone: 252-331-2050
  • Fax:
Mailing address:
  • Phone: 252-331-2050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14173
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: