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Deactivated NPI 1366640740 Deactivated / Inactive NPI Male Practitioner

Dr. Robert E Peterek , DDS

Dentist • Austin, TX

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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, Dr. Robert Peterek has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 06, 2007
NPI Deactivation Date January 22, 2019
Total Practice Duration ~12 Years of Practice (2007 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Robert Peterek, DDS was a registered Dentist practicing in Austin, TX. Throughout an active medical career spanning 12 years, Dr. Peterek provided care at the practice location at 15 WALLER ST until profile deactivation on 2019-01-22.

Practice Location & Contact Primary Location

Practice Address

15 Waller St

Austin, TX 787025240

Telephone 5129724820
Associated Practice Facility / Clinic
🏢 City Of Austin Facility NPI 1295704732

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Austin, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 19.0 Yrs
State Avg: 18.7 Yrs
Regional Practice Density
314 Specialists

Practicing in Austin, TX (6851 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 Primary Specialty

NUCC Taxonomy Code: 122300000X

State License TX 9533

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

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

18 Associated Practitioners
Alexander Davis , LP, FP-C

Emergency Medical Technician, Paramedic

NPI 1053290387

Licensed Psychologist, FPC

Abraham Wall , LCSW

Social Worker - Clinical

NPI 1053419952

Licensed Clinical Social Worker

Dr. Jon Gray , MD

Emergency Medicine

NPI 1073044384

Doctor of Medicine (M.D.)

Dr. Sileshi Assemu , DDS

Dentist - Dental Public Health

NPI 1093042111

Doctor of Dental Surgery

Sabine Berghammer , NP

Nurse Practitioner

NPI 1093431934

Nurse Practitioner

Jarred Alicea

Radiologic Technologist

NPI 1215866611

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated January 22, 2019

Record deactivated on January 22, 2019

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 15 WALLER ST, AUSTIN, TX 787025240 (Tel: 5129724820)

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Updated Business Mailing Address July 08, 2007

Registered at 110 BLUE JAY DR, LAKEWAY, TX 787345165 (Tel: 5122612424)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROBERT PETEREK, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #9533 in TX)

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Initial NPI Registration & Enumeration July 06, 2007

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: 1366640740
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 06, 2007
Last Update: July 08, 2007
Deactivation Date: January 22, 2019

Mailing Address

110 Blue Jay Dr

Lakeway, TX 787345165

Phone: 5122612424

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.