Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1417524539 Individual Practitioner Female Practitioner

Stephanie Peacock

Dentist - General Practice • La Mesa, CA

Professional Overview & Biography Verified Profile Summary

Stephanie Peacock is a registered healthcare professional specializing in Dentist - General Practice in La Mesa, CA. Practice services are available at 8530 LA MESA BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

8530 La Mesa Blvd
Unit 204

La Mesa, CA 91942

Telephone 6194942492
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in La Mesa, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 3.0 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
73 Specialists

Practicing in La Mesa, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-08-25
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 108449

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Richard Evans , DDS

Dentist - General Practice

NPI 1780673202

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location August 25, 2023

Registered at 8530 LA MESA BLVD, UNIT 204, LA MESA, CA 91942 (Tel: 6194942492)

📍
Updated Business Mailing Address August 25, 2023

Registered at 325 W WASHINGTON, SUITE 2 #3072, SAN DIEGO, CA 921031946 (Tel: 4242829707)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 25, 2023

Dentist (License #108449 in CA)

NPI Profile Active June 08, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location June 08, 2021

Registered at 714 TIVERTON AVE, LOS ANGELES, CA 900958361 (Tel: 3109610731)

📍
Updated Business Mailing Address June 08, 2021

Registered at 10870 WELLWORTH AVE, LOS ANGELES, CA 900244917

👤
Provider Name / Credentials Updated June 08, 2021

Recorded as STEPHANIE PEACOCK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 08, 2021

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration June 08, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1417524539
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 08, 2021
Last Update: August 25, 2023
Sole Proprietor: No

Mailing Address

325 W Washington, Suite 2 #3072

San Diego, CA 921031946

Phone: 4242829707

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.