Healthcare Provider Details

I. General information

NPI: 1730317546
Provider Name (Legal Business Name): JAMES CALVIN PECK JR. D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13901 PARKWAY COMMONS DR STE D
OKLAHOMA CITY OK
73134-6225
US

IV. Provider business mailing address

18001 N WESTERN AVE STE 106
EDMOND OK
73012
US

V. Phone/Fax

Practice location:
  • Phone: 405-500-7004
  • Fax: 405-857-3131
Mailing address:
  • Phone: 405-562-9550
  • Fax: 405-562-9551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6111
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: