Provider Demographics
NPI:1831118561
Name:PEPIS, RICK W (DDS)
Entity type:Individual
Prefix:DR
First Name:RICK
Middle Name:W
Last Name:PEPIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7899 BAYMEADOWS WAY
Mailing Address - Street 2:SUITE#3
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7572
Mailing Address - Country:US
Mailing Address - Phone:904-731-5200
Mailing Address - Fax:904-737-2427
Practice Address - Street 1:7899 BAYMEADOWS WAY
Practice Address - Street 2:SUITE#3
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7572
Practice Address - Country:US
Practice Address - Phone:904-731-5200
Practice Address - Fax:904-737-2427
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL85951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice