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General NPI Number Information
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NPI Number | 1871894949
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Entity Type | Individual
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Provider Name | JEFFREY DANIEL PEIFER DMD
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Gender | Male
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Dates
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Enumeration Date | 11/05/2010
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 2680 S VAL VISTA DR STE 161
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City | GILBERT
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State | AZ
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Zip | 85295
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Country | US
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Telephone | 480-782-8825
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Fax | 480-782-8815
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Provider Business Mailing Address
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Address Line | 4015 E FAIRFIELD ST
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City | MESA
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State | AZ
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Zip | 85205-5007
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Country | US
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Telephone | 480-600-4717
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 59457
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8199
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License Number State | AZ
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