| Erena & Peterson, Pllc | |
|
620 Perimeter Dr Suite 100 Lexington KY 40517-4125 | |
| (859) 268-4423 | |
| (859) 268-0010 |
| Full Name | Erena & Peterson, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 620 Perimeter Dr, Lexington, Kentucky |
| Authorized Official Name and Position | Sharon L. Hinton (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 8592684423 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Erena & Peterson, Pllc 620 Perimeter Dr Suite 100 Lexington KY 40517-4125 Ph: (859) 268-4423 | Erena & Peterson, Pllc 620 Perimeter Dr Suite 100 Lexington KY 40517-4125 Ph: (859) 268-4423 |
| NPI Number | 1285942649 |
|---|---|
| Provider Enumeration Date | 09/20/2010 |
| Last Update Date | 07/06/2011 |
| Medicare PECOS PAC ID | 2466633342 |
|---|---|
| Medicare Enrollment ID | O20110225000013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285942649 | NPI | - | NPPES |
| 7100158900 | Other | KY | MEDICAID MEDICAL |
| 7100150110 | Other | KY | MEDICAID DENTAL |
| P100036989 | Other | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| 204E00000X | Oral & Maxillofacial Surgery | (* (Not Available)) | Secondary |
| Provider Name | Gilman P Peterson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1871756924 PECOS PAC ID: 5890847388 Enrollment ID: I20090714000561 |
| Provider Name | Donald R Mclaurin |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1265518187 PECOS PAC ID: 9739228107 Enrollment ID: I20091124000175 |
| Provider Name | Gregory Ralph Erena |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1053317214 PECOS PAC ID: 6002864139 Enrollment ID: I20100625000576 |
| Provider Name | William Michael Sexton |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1366676603 PECOS PAC ID: 3870805906 Enrollment ID: I20150702001068 |
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