DR. PETER M TAN JR. (NPI# 1932585916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932585916 |
| Entity Type | Individual |
| Full Name | DR. PETER M TAN JR. |
| Credential | DDS |
| Practice Address |
14679 Apple Harvest Dr Ste 100 Martinsburg WV 25401-3703 |
| Mailing Address |
1553 Hugo Cir Silver Spring MD 20906-5918 |
| Practice Telephone | 3047079674 |
| Mailing Telephone | 3016392536 |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2020-09-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 15999 | MD | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
4367 | WV | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7710 Sightseeing Rd, Bldg 2826, Fort Benning, GA 319053764 | 7065443103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013060284 | Peter B Tan | Physical Therapist | 765 Sereno Dr, Vallejo, CA 94589-2415 | 2007-01-19 |
| 1639141609 | Peter M Tan | Oral & Maxillofacial Surgery | 68 Thomas Johnson Dr, Suite A, Frederick, MD 21702 | 2006-02-03 |
| 1144228909 | Peter Xuepeng Tan | Internal Medicine | 117 E Live Oak Ave, Suite 101, Arcadia, CA 91006-5269 | 2005-07-14 |
| 1184113763 | Peter Tan | Physician Assistant | 34612 6th Ave S Ste 300, Federal Way, WA 98003-8723 | 2018-05-09 |
| 1750305272 | Peter H. Tan | Pathology | 13100 Fort King Rd, Dade City, FL 33525-5294 | 2006-07-27 |
| Street Address |
14679 APPLE HARVEST DR STE 100 |
| City | MARTINSBURG |
| State | WV |
| Zip Code | 25401-3703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235693706 | Vida Wilhelmina Adjepon-yamoah | Dentist | 14679 Apple Harvest Dr Ste 100, Martinsburg, WV 25401-3703 | 2019-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962020537 | Christina Anne Williams | Nurse Practitioner | 2100 Hospital Drive, Martinsburg, WV 25401 | 2020-07-10 |
| 1013530633 | Pdi Health Wv LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 126 E. Burke Street, Martinsburg, WV 25401 | 2020-05-19 |
| 1699293035 | Tiffany Curry | Social Worker | 653 Winchester Avenue, Martinsburg, WV 25401 | 2017-09-06 |
| 1972042992 | Berkeley County Council | Counselor | 800 Emmett Rousch Drive, Martinsburg, WV 25401 | 2017-02-23 |
| 1023569449 | Heidi Crawford | Registered Nurse | 401 South College Street, Berkeley County Board of Ed, Martinsburg, WV 25401 | 2016-10-20 |
| 1578911293 | Christina Marie Van Hilst | Nurse Practitioner | 1001 Sushruta Dr, Martinsburg, WV 25401 | 2016-06-03 |
| 1578926549 | Barathy Radhakrishnan | Speech-Language Pathologist | 401 Queen Street, Berkeley County Board of Education, Martinsburg, WV 25401 | 2016-03-29 |
| 1972985638 | Wellco Dme LLC | Durable Medical Equipment & Medical Supplies | 107 Tavern Rd, Martinsburg, WV 25401 | 2015-06-18 |
| 1457731960 | Patrick Hamilton Noland | Dentist | 1003 Sushruta Dr., Martinsburg, WV 25401 | 2015-06-01 |
| 1801296330 | Terry Harden | Massage Therapist | 601 South Raliegh St., Martinsburg, WV 25401 | 2014-09-03 |
| Find all providers in zip 25401 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255544748 | Nahla Chaudhary | Dentist | 1007 Sushruta Dr, Martinsburg, WV 25401-8876 | 2007-05-08 |
| 1215010285 | Willard Dean Russell Jr. | Dentist | 1007 Sushruta Drive, Martinsburg, WV 25401 | 2006-10-23 |
| 1346310505 | Associated Oral & Maxillofacial Surgeons, PC | Dentist | 1007 Sushruta Drive, Martinsburg, WV 25401 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194255620 | William Black | Dentist | Room 1200 Hsc North, P.o. Box 9475, Morgantown, WV 26506 | 2017-06-18 |
| 1104359959 | Appalachian Oral Surgery Center | Dentist | 3433 University Ave, Suite 1, Morgantown, WV 26505-3052 | 2017-04-09 |
| 1023318201 | James G Bryant Dmd | Dentist | 5000 Hampton Ctr Ste 1, Morgantown, WV 26505-1709 | 2010-10-22 |
| 1053561779 | Drs Krajekian,brock & Henderson Inc | Dentist | 3135 16th Street Rd, Suite 20, Huntington, WV 25701 | 2008-09-30 |
| 1164646725 | William A. Myers II Dmd Ltd | Dentist | 1191 Pineview Dr Ste D, Morgantown, WV 26505-2778 | 2007-04-12 |
| 1780729251 | Babak D. Noorbakhsh | Dentist | 2801 Dudley Ave Ste C, Parkersburg, WV 26101-2105 | 2007-02-21 |
| 1659442309 | Edward Elias Howard | Dentist | 1321 Virginia St E, Charleston, WV 25301 | 2006-11-13 |
| 1376614024 | Richard Lee Howard | Dentist | 1321 Virginia St East, Charleston, WV 25301 | 2006-11-13 |
| 1356420186 | Peter James Pangilinan | Dentist | 700 W Pike St, Suite 100, Clarksburg, WV 26301-2696 | 2006-11-03 |
| 1265511091 | David A Lattanzi | Dentist | 700 West Pike Street, Suite 100, Clarksburg, WV 26301 | 2006-11-03 |
| Find all providers with the same taxonomy | ||||
| City | MARTINSBURG |
| Zip Code | 25401 |
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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.