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Deactivated NPI 1235243189 Deactivated / Inactive NPI Male Practitioner

Ivan Pelton

Dentist - General Practice • Wyomissing, PA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Ivan Pelton has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 18, 2006
NPI Deactivation Date November 27, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Ivan Pelton was a registered Dentist - General Practice practicing in Wyomissing, PA. Throughout an active medical career spanning 19 years, Ivan Pelton provided care at the practice location at 1301 PENN AVE until profile deactivation on 2025-11-27.

Practice Location & Contact Primary Location

Practice Address

1301 Penn Ave

Wyomissing, PA 196102140

Telephone 6103726313
Associated Practice Facility / Clinic
🏢 Amdent Ltd Facility NPI 1558446146

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Wyomissing, PA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.0 Yrs
Regional Practice Density
44 Specialists

Practicing in Wyomissing, PA (4936 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

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License FL DN5838

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

12 Associated Practitioners
Jay Toran

Dentist - General Practice

NPI 1013021955
NPI 1174079727

Doctor of Dental Medicine

Dr. Vincent Gerardi , DMD

Dentist - Orthodontics and Dentofacial Orthopedics

NPI 1437263373

Doctor of Dental Medicine

John Mcintyre

Dentist - Orthodontics and Dentofacial Orthopedics

NPI 1487740718
Steven Goldberg

Dentist - Oral and Maxillofacial Surgery

NPI 1538272026
Zukang Jiang

Dentist - General Practice

NPI 1659443588

Career & Practice History Timeline

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

13 Historical Events
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NPI Profile Deactivated November 27, 2025

Record deactivated on November 27, 2025

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2018

Dentist (License #DN5838 in FL)

NPI Profile Active September 28, 2017

NPI status registered as active in NPPES database

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Updated Practice Location September 28, 2017

Registered at 12558 PINES BLVD, PEMBROKE PINES, FL 330271713 (Tel: (954) 639-6998)

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Updated Business Mailing Address September 28, 2017

Registered at 12558 PINES BLVD, PEMBROKE PINES, FL 330271713 (Tel: (954) 639-6998)

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Provider Name / Credentials Updated September 28, 2017

Recorded as IVAN PELTON

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 28, 2017

Dentist (License #DN15585 in FL)

NPI Profile Active June 29, 2011

NPI status registered as active in NPPES database

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Updated Practice Location June 29, 2011

Registered at 1301 PENN AVE, WYOMISSING, PA 196102140 (Tel: 6103726313)

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Updated Business Mailing Address June 29, 2011

Registered at 1301 PENN AVE, WYOMISSING, PA 196102140 (Tel: 6103726313)

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Provider Name / Credentials Updated June 29, 2011

Recorded as IVAN PELTON

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 29, 2011

Dentist (License #DN5838 in FL)

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Initial NPI Registration & Enumeration August 18, 2006

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: 1235243189
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 18, 2006
Last Update: June 29, 2011
Deactivation Date: November 27, 2025

Mailing Address

1301 Penn Ave

Wyomissing, PA 196102140

Phone: 6103726313

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.