Provider Demographics
NPI:1871894949
Name:PEIFER, JEFFREY DANIEL (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DANIEL
Last Name:PEIFER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4015 E FAIRFIELD ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-5007
Mailing Address - Country:US
Mailing Address - Phone:480-600-4717
Mailing Address - Fax:
Practice Address - Street 1:2680 S VAL VISTA DR STE 161
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295
Practice Address - Country:US
Practice Address - Phone:480-782-8825
Practice Address - Fax:480-782-8815
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59457122300000X
AZ8199122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist