NPIMap

Organization Active NPI

Keller Pediatric Dentistry

  • Pediatric Dentistry
  • Keller, TX
National Provider Identifier
1043471311
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
14921 Issued in TX
Legal business name
KELLER PEDIATRIC DENTISTRY
Practice address
1858 Keller Pkwy
Suite 100
Keller, TX 76248-3757
Phone
(817) 431-6008
Fax
(817) 337-0098
NPI assigned
Jun 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Dr. Daniel E Donohue, DDSNPI 1174611610
Title
Dentist
Phone
(817) 431-6008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 14921 TX Primary

Addresses

Primary practice location

1858 Keller Pkwy
Suite 100
Keller, TX 76248-3757

Mailing address

1858 Keller Pkwy
Suite 100
Keller, TX 76248-3757
Phone (817) 431-6008

National Provider Directory

National Provider Directory

Locations

1858 Keller Pkwy
Ste 100
Keller, TX 76248
Phone (817) 431-6008

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1043471311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1858 KELLER PKWY",
            "address_2": "SUITE 100",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483757",
            "telephone_number": "817-431-6008",
            "fax_number": "817-337-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1858 KELLER PKWY",
            "address_2": "SUITE 100",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483757",
            "telephone_number": "817-431-6008",
            "fax_number": "817-337-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLER PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-19",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "DONOHUE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "817-431-6008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "14921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.