Individual provider Active NPI

Susan Huang Keefe

  • Dentist
  • Chapel Hill, NC
National Provider Identifier
1053056325
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12853 Issued in NC
Practice address
120 Dental Cir
Chapel Hill, NC 27599-5021
Phone
(919) 537-3944
NPI assigned
May 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12853 NC Primary

Addresses

Primary practice location

120 Dental Cir
Chapel Hill, NC 27599-5021

Mailing address

8010 Sundance Cir
Durham, NC 27713-5919
Phone (718) 839-3909

Other names 1

  • Pengqian Huang Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220708001417 NC Order and Referring Only - DentistPractitioner - Dentist 1557741576

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12853NCMDDentist

Interoperability endpoints

  • Direct secure messaging: skeefe576825@directhisp.wakemed.org
  • Direct secure messaging: skeefe873731@direct.unc.nchie.net

NPI Registry JSON

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1053056325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 SUNDANCE CIR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277135919",
            "telephone_number": "718-839-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 DENTAL CIR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275995021",
            "telephone_number": "919-537-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFE",
        "first_name": "SUSAN",
        "middle_name": "HUANG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "12853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENGQIAN",
            "last_name": "HUANG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.