Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. PETER MICHAEL NOVOTNY JR. DMD
NPI 1154247633
Dentist in Fort Defiance, AZ

Q: What is Peter Novotny's NPI number?

The NPI number for Peter Novotny is 1154247633. It was assigned to this individual provider in the NPPES registry on June 29, 2026.

Q: What is Peter Novotny's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Peter Novotny was last updated on August 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 50 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 29, 2026PECOS Enrolled

CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504(928) 729-8000 Get Directions Write a Review

NPPES record last updated: August 31, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Dr. Peter Michael Novotny Jr. Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PETER MICHAEL NOVOTNY JR. DMD (NPI 1154247633) is an individual dentist in Fort Defiance, Arizona, licensed in Florida (DN32097) and active in the NPI registry since June 2026. He is enrolled in Medicare PECOS and is a graduate of Other (2026).

NPPES Registry Identity

NPI1154247633

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. PETER MICHAEL NOVOTNY JR.Credential: DMD

Location AddressCORNER OF ROUTE N12 AND N7Fort Defiance, AZ 86504-0649

Mailing AddressPo Box 649Fort Defiance, AZ 86504-0649

Phone(928) 729-8000

Sole ProprietorNo

Medical School CMSOtherGraduated 2026

Enumeration DateJune 29, 2026

Last NPPES UpdateAugust 31, 2026

NPPES CertifiedAugust 31, 2026

✔ NPI 1154247633 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in FL · DN32097

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

CORNER OF ROUTE N12 AND N7, Fort Defiance, AZ 86504

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Peter Michael Novotny Jr. Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3173080934

PECOS Enrollment IDI20260811005096

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Peter Novotny reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

The Fort Defiance Indian Hospital Board, Incorporation

3.8 mi

General Acute Care Hospital

CORNER OF ROUTE N12 & N7
Fort Defiance, AZ 86504

Reassigned Medicare billing, Texas enrollment
518 clinicians in this Medicare group

NPI 1477876639 (928) 729-8000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86504 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$69.24 typical visit price

range $17.72 – $137.41

Typical copayment $17.31 (range $4.43 – $34.35)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROMULO LAURETA PARUNGAO M.D.

Emergency Medicine

CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504

Apache County (928) 729-8600

CHARLES EATON PAGE

Emergency Medicine

CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504

Apache County (928) 729-8000

JAY S GUIKEMA FNP

Nurse Practitioner (Family)

CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504

Apache County (928) 729-8000

MARIBEL PASTRAN RD, CD

Dietitian, Registered

CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504

Apache County (928) 729-8000

PONY NANCY SOKIRI PA-C

Physician Assistant

CORNER OF ROUTE N12 AND N7, CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504

Apache County (928) 729-8000

SARAH R WILLIAMS PT

Physical Therapist

CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504

Apache County (928) 729-8000

JOHN NORBERT

Family Medicine

CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504

Apache County (928) 729-8000

DR. LINDA BROWN TRUDEL MD

Family Medicine

CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ 86504

Apache County (928) 729-8000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peter Novotny's NPI number?

The NPI number for Peter Novotny is 1154247633. It was assigned to this individual provider in the NPPES registry on June 29, 2026.

Where is Peter Novotny located?

Peter Novotny practices at Corner Of Route N12 And N7, Fort Defiance, AZ 86504. The listed phone number is (928) 729-8000.

What is Peter Novotny's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Peter Novotny enrolled in Medicare?

Yes. Peter Novotny is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Peter Novotny's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Peter Novotny reassigns Medicare benefits to The Fort Defiance Indian Hospital Board, Incorporation (Fort Defiance, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Peter Novotny's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Peter Novotny was last updated on August 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 50 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.