DR. ZACHARY SCOTT PEACOCK (NPI# 1457587065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457587065 |
| Entity Type | Individual |
| Full Name | DR. ZACHARY SCOTT PEACOCK |
| Credential | M.D., D.M.D. |
| Practice Address |
55 Fruit Street, Warren 1201 Boston MA 02114-2621 |
| Practice Telephone | 6177262740 |
| Practice Fax Number | 6177266195 |
| Mailing Telephone | 6177262740 |
| Mailing Fax Number | 6177266195 |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2014-07-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | A106669 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
55 FRUIT STREET, WARREN 1201 |
| City | BOSTON |
| State | MA |
| Zip Code | 02114-2621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588276281 | Guoliang Qiao | Student in an Organized Health Care Education/Training Program | Massachusetts General Hospital, 55 Fruit Street., Boston, MA 02114 | 2020-08-24 |
| 1881223741 | Alexander Wesley Zirulnik | Student in an Organized Health Care Education/Training Program | 55 Fruit St. Boston, Boston, MA 02114 | 2020-04-03 |
| 1376170548 | Mia Yu Bothwell | Student in an Organized Health Care Education/Training Program | Gray Bigelow 730, 55 Fruit Street, Boston, MA 02114 | 2020-03-26 |
| 1225661036 | David Dongkyung Kim | Student in an Organized Health Care Education/Training Program | 6 Whittier Place, Apartment 15b, Boston, MA 02114 | 2020-02-20 |
| 1124651658 | Madeleine Sertic | Student in an Organized Health Care Education/Training Program | Division of Abdominal Imaging, Department of Radiology, 55 Fruit Street, White 270, Boston, MA 02114 | 2020-02-12 |
| 1285274498 | Jiuk James Jung | Student in an Organized Health Care Education/Training Program | 15 Parkman Ave, Wang 4-460, Boston, MA 02114 | 2020-01-15 |
| 1831740448 | Jennifer Hughes | Physician Assistant | 55 Fruit Street, Founders 110, Boston, MA 02114 | 2019-09-25 |
| 1558827220 | Aluma Chovel Sella | Student in an Organized Health Care Education/Training Program | Massgeneral Hospital for Children Main Campus, 55 Fruit Street, Boston, MA 02114 | 2019-02-18 |
| 1083187140 | Henry Oliveras | Massage Therapist | 102 Charles Street, Boston, MA 02114 | 2019-01-10 |
| 1720550031 | Nicole M Price | Social Worker | 29 Staniford St, Boston, MA 02114 | 2018-12-27 |
| Find all providers in zip 02114 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518452705 | Yisi D Ji | Oral & Maxillofacial Surgery | 165 Cambridge St Ste 401, Mgh Dental Group, Boston, MA 02114-2750 | 2018-06-29 |
| 1851580708 | Basim Jamal | Oral & Maxillofacial Surgery | 820 Harrison Ave, Fgh Building 4th Floor, Boston, MA 02118-2905 | 2007-10-16 |
| 1265447965 | Edward T Lahey IIi | Oral & Maxillofacial Surgery | 15 Parkman St Wac 230, Oral & Maxillofacial Surgery, Boston, MA 02114 | 2006-07-30 |
| 1720062284 | Lisa Campanella | Oral & Maxillofacial Surgery | 55 Fruit Street Cpz 401, Massachusetts General Hospital, Boston, MA 02114 | 2005-11-30 |
| 1689299927 | Grace Hsu | Oral & Maxillofacial Surgery | 55 Fruit St, Massachusetts General Hospital, Boston, MA 02114-2621 | 2020-06-12 |
| 1063037778 | Nancy Zhu | Oral & Maxillofacial Surgery | 55 Fruit St, Massachusetts General Hospital, Boston, MA 02114-2621 | 2020-06-09 |
| 1821612086 | Taylor M Vanhouten | Oral & Maxillofacial Surgery | 55 Fruit St, Massachusetts General Hospital, Boston, MA 02114-2621 | 2020-06-03 |
| 1740804277 | Tapan P Dalal | Oral & Maxillofacial Surgery | 55 Fruit St, Massachusetts General Hospital, Boston, MA 02114-2621 | 2020-06-01 |
| 1659995181 | Kate E Mcpherson | Oral & Maxillofacial Surgery | 55 Fruit St, Massachusetts General Hospital, Boston, MA 02114-2621 | 2020-06-01 |
| 1568086098 | Sahil Gandotra | Oral & Maxillofacial Surgery | 55 Fruit St, Massachusetts General Hospital, Boston, MA 02114-2621 | 2020-06-01 |
| Find all providers in BOSTON | ||||
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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.