IndividualActive
Kenneth Peavy, D.M.D.
NPI 1447394556 · Periodontics · Winston Salem, NC
Provider details
- NPI number
- 1447394556
- Entity type
- Individual
- Primary specialty
- PeriodonticsDental Providers
- Credential
- D.M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 5876 (NC)
Specialties & taxonomies
Dental Providers
Practice location
1400 Westgate Center Dr
Suite 204
Winston Salem, NC 27103-3104
Phone: (336) 774-3001
Fax: (336) 774-9161
Approximate (ZIP-level) locationGet directions
Mailing address
1400 Westgate Center Dr
Winston Salem, NC 27103-3104
Registry dates
- Enumerated
- 2007-02-20
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.