Provider Demographics
NPI:1477849511
Name:PEIFER, SCOTT M (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:M
Last Name:PEIFER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7891 TALBERT AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-8613
Mailing Address - Country:US
Mailing Address - Phone:714-842-2521
Mailing Address - Fax:714-842-1083
Practice Address - Street 1:7891 TALBERT AVE STE 101
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-8613
Practice Address - Country:US
Practice Address - Phone:714-842-2521
Practice Address - Fax:714-842-1083
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN42000407A1223S0112X
IN12011786A1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery