DR. JOHN DAVID PEACOCK (NPI# 1306982921) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306982921 |
| Entity Type | Individual |
| Full Name | DR. JOHN DAVID PEACOCK |
| Credential | DDS, FAGD |
| Practice Address |
24 Waleska St Canton GA 30114-2739 |
| Mailing Address |
2250 Brick Mill Rd Canton GA 30115-9125 |
| Practice Telephone | 7704795569 |
| Mailing Telephone | 7708911904 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2015-05-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN008073 | GA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528280807 | John Charles Peacock Sr. | Pharmacist | 3621 Us Hwy 231 North, Panama City, FL 32404 | 2007-05-03 |
| 1780697722 | John C. Peacock | Counselor | 321 Port Dr, Madison, TN 37115-3424 | 2006-08-14 |
| 1780213926 | John Peacock | Student in an Organized Health Care Education/Training Program | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-04-08 |
| 1972819167 | John Michael Peacock | Case Manager/Care Coordinator | 456 Elm Ave, Long Beach, CA 90802-2426 | 2010-08-25 |
| 1699840991 | John Martin Peacock | Dentist | 320 N Mclean Blvd, Elgin, IL 60123 | 2006-11-21 |
| 1881763613 | John Edward Peacock IIi | Family Medicine | 10000 Shannondell Dr, Audubon, PA 19403-5615 | 2006-11-07 |
| 1285670752 | John Hollis Peacock | Psychiatry & Neurology | 1000 Locust St, Va111, Reno, NV 89502-2597 | 2006-06-21 |
| 1700883725 | John Charles Peacock Jr. | Urology | 1118 Ross Clark Cir, 500, Dothan, AL 36301-3001 | 2005-07-05 |
| Street Address |
24 WALESKA ST |
| City | CANTON |
| State | GA |
| Zip Code | 30114-2739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467406827 | Kenneth Owen Logan | Chiropractor | 24 Waleska St, Suite 100, Canton, GA 30114-2739 | 2006-05-20 |
| 1043581671 | Preferred Psychological Service, LLC | Counselor | 24 Waleska St, Suite 100, Canton, GA 30114-2739 | 2012-01-12 |
| 1184891780 | William Greg Elwell | Dentist | 24 Waleska St, Canton, GA 30114-2739 | 2008-05-13 |
| 1477720076 | Louis Michael Cox | Dentist | 24 Waleska St, Canton, GA 30114-2739 | 2008-05-13 |
| 1124105507 | Greg Elwell, D.m.d., P.C. | Dentist | 24 Waleska St, Canton, GA 30114-2739 | 2006-11-01 |
| 1699713388 | Logan Family Chiropractic PC | Chiropractor | 24 Waleska St, Suite 100, Canton, GA 30114-2739 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619516093 | Wickshire Canton Opco LLC | Assisted Living Facility | 125 Riverstone Terrace, Canton, GA 30114 | 2020-01-02 |
| 1154803583 | Alixandra Nicole Flournoy | Physical Therapist | 131 Holly Street, Canton, GA 30114 | 2018-09-01 |
| 1588157341 | Provident Group - Canton Cove Properties LLC | Alzheimer Center (Dementia Center) | 1100 Reinhardt College Parkway, Canton, GA 30114 | 2018-06-07 |
| 1003233107 | Heartland Dental Care of Georgia | Dentist | 3237 Sixes Rd, Canton, GA 30114 | 2014-03-26 |
| 1730510959 | Joseph Optical | Eyewear Supplier (Equipment, not the service) | 1455 Riverstone Pkwy Suite 110, Canton, GA 30114 | 2013-12-13 |
| 1629313036 | Ramona Morton Rasmussen | Occupational Therapist | 200 Riverstone Drive, Suite B, Canton, GA 30114 | 2012-12-11 |
| 1902154875 | Yong Qiao Luo | Acupuncturist | 200 Oakside Lane, Suite D, Canton, GA 30114 | 2012-08-26 |
| 1215294350 | Christina Lynn Hernandez | Pediatrics | 1558 Riverstone Pkwy Ste 100, Canton, GA 30114 | 2012-04-13 |
| 1558638981 | Stephen E Byrd | Counselor | 191 Lamar Haley Pkwy., Canton, GA 30114 | 2011-11-30 |
| 1073807855 | Sheri Sullins Buckley | Nurse Practitioner | 120 Oakside Ct Ste H, Canton, GA 30114 | 2011-06-08 |
| Find all providers in zip 30114 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760008361 | Portable Smiles Mobile Inc | Dentist | 519 Pinehurst Dr, Canton, MI 48188-3078 | 2020-06-19 |
| 1740825207 | Vlp Can LLC | Dentist | 39883 Ford Rd., Canton, MI 48187 | 2019-11-08 |
| 1669014403 | Flossed LLC | Dentist | 500 Chapman St Unit 201, Canton, MA 02021-2040 | 2019-10-14 |
| 1164078960 | Caleb Jonathon Fuller | Dentist | 46592 W Oak Manor Ct, Canton, MI 48187-5230 | 2019-08-16 |
| 1518527191 | Pediatric Dentistry | Dentist | 45535 Hanford Rd, Canton, MI 48187-4595 | 2019-06-17 |
| 1710546148 | Georgia Dental Professionals, PC | Dentist | 8022 Cumming Hwy, Canton, GA 30115-9337 | 2019-06-10 |
| 1891267316 | Canton Marketplace Dentistry LLC | Dentist | 1810 Cumming Hwy Ste 900, Canton, GA 30115-2999 | 2018-12-21 |
| 1548754252 | Ashvi Mittal | Dentist | 248 Taylors Farm Dr, Canton, GA 30115-9023 | 2018-06-15 |
| 1285127605 | Cameron Parker Demarsh | Dentist | 2414 Whipple Ave Nw, Canton, OH 44708-1514 | 2018-06-11 |
| 1184146318 | Cherokee Family Dental East Cherokee LLC | Dentist | 7768 Cumming Hwy Ste 100, Canton, GA 30115-2982 | 2017-07-10 |
| Find all providers in CANTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.