Keith Fetterolf, DMD, P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KEITH FETTEROLF, DMD, P.A.

Practice address

142 Shenstone LN
Garner, NC 27529-6902

Phone

(919) 329-6101

NPI assigned

Aug 8, 2022

Organization subpart

No

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

Authorized official

Name

Keith Fetterolf, DMDNPI 1750418935

Title

Owner

Phone

(919) 329-6101

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keith Robert Fetterolf, DMD

  • General Practice Dentistry
  • Garner, NC
  • NPI 1750418935
  NPD Authorized official

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1023745130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 SHENSTONE LN",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275296902",
            "telephone_number": "919-329-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 SHENSTONE LN",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275296902",
            "telephone_number": "919-329-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH FETTEROLF, DMD, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "FETTEROLF",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-329-6101",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Keaton
• Bethany Keeler, LCSW
• Marian Jeanette Keen, PHYSICIAN ASSISTANT
• Stephen Michael Keen, MD
• Angela Horne Keene, N. P.
• Lisa Kelbaugh, LPCA
• Kristina Keltner, FNP
• Katie L Kepner, P.T.
• William Stewart Ketcham, M.D.
• Kevin Arthur DDS PA

• General Practice Dentistry in Garner, NC
• Providers in Garner, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.