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NPI Code Detail

MEDICARE: DR. VIRGINIA COLE PEEK DMD

MEDICARE: DR. VIRGINIA COLE PEEK DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDN123104GA

General Provider Information

NPI Number : 1730866468
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VIRGINIA COLE PEEK DMD
Provider Business Mailing Address
First Line : 2905 OLD RIVER RD
Second Line :
City : FORTSON
State : GA
Zip : 31808-4233
Country : US
Telephone Number : 229-881-4454
Fax Number :
Provider Business Practice Location Address
First Line : 7371 BLACKMON RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-4478
Country : US
Telephone Number : 706-327-4513
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2023
Last Update Date : 08/18/2025

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