Organization Active NPI

Dr Douglas a Keller DMD PC

  • General Practice Dentistry
  • Babylon, NY
National Provider Identifier
1043470537
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
035664 Issued in NY
Legal business name
DR DOUGLAS A KELLER DMD PC
Practice address
420 West Montauk Highway
Babylon, NY 11702
Phone
(631) 669-0027
Fax
(631) 669-0054
NPI assigned
Jun 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Authorized official

Name
Dr. Douglas Alan Keller, DMD
Title
Dentist/Owner
Phone
(631) 669-0027

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 035664 NY Primary

Addresses

Primary practice location

420 West Montauk Highway
Babylon, NY 11702

Mailing address

420 West Montauk Highway
Babylon, NY 11702
Phone (631) 669-0027

National Provider Directory

National Provider Directory
Tax ID family
Dr Douglas a Keller DMD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

420 W Montauk Hwy
Babylon, NY 11702
Phone (631) 661-0545

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1043470537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 WEST MONTAUK HIGHWAY",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "11702",
            "telephone_number": "631-669-0027",
            "fax_number": "631-669-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 WEST MONTAUK HIGHWAY",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "11702",
            "telephone_number": "631-669-0027",
            "fax_number": "631-669-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DOUGLAS A KELLER DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-10",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "631-669-0027",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "035664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Babylon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; 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.