GEOFFREY GLEN PENA DMD
NPI 1962014282
Dentist - General Practice in Tracy, CA
About Geoffrey Glen Pena Dmd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GEOFFREY GLEN PENA DMD (NPI 1962014282) is an individual general practice provider in Tracy, California, licensed in California (105245) and active in the NPI registry since August 2020. He is enrolled in Medicare PECOS and is a graduate of Univ Of Nevada, Las Vegas School Of Dental Med (2020).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Geoffrey Glen Pena Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Geoffrey Pena reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Ukiah, CA 95482
- Reassigned Medicare billing, California enrollment
- 121 clinicians in this Medicare group
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 95376 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Geoffrey Pena's NPI number?
The NPI number for Geoffrey Pena is 1962014282. It was assigned to this individual provider in the NPPES registry on August 18, 2020.
Where is Geoffrey Pena located?
Geoffrey Pena practices at 1401 W 11th St Ste A, Tracy, CA 95376. The listed phone number is (209) 830-7477.
What is Geoffrey Pena's specialty?
The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.
Is Geoffrey Pena enrolled in Medicare?
Yes. Geoffrey Pena is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Geoffrey Pena's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Geoffrey Pena reassigns Medicare benefits to Mendocino Community Health Clinic, Inc. (Ukiah, CA). 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 Geoffrey Pena's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Geoffrey Pena accept?
Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, HRI Dental & Vision and Humana and 3 other insurers list Geoffrey Pena as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Geoffrey Pena was last updated on August 18, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.
# Geoffrey Glen Pena, DMD · NPI 1962014282
General Practice provider in Tracy, California. Individual provider, active in the CMS NPPES registry since August 18, 2020.
## Identity
- **NPI:** 1962014282 (Entity type: Individual)
- **Enumerated:** August 18, 2020
- **Primary specialty:** Dentist - General Practice · taxonomy 1223G0001X
- **State license:** 105245 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1401 W 11TH ST STE A, Tracy, CA 95376-3702
- **Phone:** (209) 830-7477
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Mendocino Community Health Clinic, Inc. (NPI 1497961106, Ukiah, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Univ Of Nevada, Las Vegas School Of Dental Med, class of 2020
## Record status
- **NPPES last updated:** August 18, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1962014282) · Data from the CMS NPPES public registry.