Karl a Keller DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

019017215 Issued in IL

Legal business name

KARL A KELLER DDS PC

Practice address

312 W Division St
Manteno, IL 60950

Phone

(815) 468-6800

Fax

(815) 468-7780

NPI assigned

Dec 11, 2006

Last updated

Mar 23, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Karl A Keller, DDSNPI 1972862787

Title

President

Phone

(815) 468-6800

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Karl A Keller, D.D.S.

  • Dentist
  • Manteno, IL
  • NPI 1972862787
  NPD (past) Authorized official
• Douglas M Keller, DMD

  • Dentist
  • Manteno, IL
  • NPI 1316432909
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332460800000",
    "number": "1023178985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 W DIVISION ST",
            "city": "MANTENO",
            "state": "IL",
            "postal_code": "60950",
            "telephone_number": "815-468-6800",
            "fax_number": "815-468-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 W DIVISION ST",
            "city": "MANTENO",
            "state": "IL",
            "postal_code": "60950",
            "telephone_number": "815-468-6800",
            "fax_number": "815-468-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KARL A KELLER DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2012-03-23",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "KARL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-468-6800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019017215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iroquois Mental Health Center
• Jeffrey Jackson
• Gregory Jen, CADC
• Betul Kan
• Kankakee Valley Dialysis Network (Manteno Dialysis Centre)
• Kayleigh Kastelein
• Sophia Keigher
• Douglas M Keller, DMD
• Karl A Keller, D.D.S.
• Sonia G Kladis

• Dentist in Manteno, IL
• Providers in Manteno, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.