Active NPI
Keely Christina Goter, D.D.S.
- General Practice Dentistry
- Hazen, ND
National Provider Identifier
1053868026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2298
- Practice address
- 204 2ND Ave NE
Hazen, ND 58545-4420 - Phone
- (701) 748-2730
- NPI assigned
- Sep 7, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2298 | ND | Primary |
Addresses
Primary practice location
204 2ND Ave NE
Hazen, ND 58545-4420
Mailing address
808 3Rd Ave NE
Mandan, ND 58554-3220
Phone (701) 663-0389
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2298 | ND | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Priscila J Jelsing DDS PC | Past | Accepting new patients | |
| Mark E. Jahraus, DDS, PC | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Hazen, ND
- NPI 1952692451
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473206400000",
"number": "1053868026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 3RD AVE NE",
"city": "MANDAN",
"state": "ND",
"postal_code": "585543220",
"telephone_number": "701-663-0389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 2ND AVE NE",
"city": "HAZEN",
"state": "ND",
"postal_code": "585454420",
"telephone_number": "701-748-2730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTER",
"first_name": "KEELY",
"middle_name": "CHRISTINA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-07",
"last_updated": "2016-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ND",
"license": "2298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hazen, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.