Columbus Children's Dentistry, PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN014428 Issued in GA

Legal business name

COLUMBUS CHILDREN'S DENTISTRY, PC

Practice address

4405 N Stadium Dr
Suite B
Columbus, GA 31909-1878

Phone

(706) 225-0444

Fax

(706) 940-0008

NPI assigned

Jul 7, 2014

Last updated

Jul 7, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Lee Keller, DMDNPI 1134495591

Title

Dentist/Owner

Phone

(706) 225-0444

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Keller, D.M.D.

  • Pediatric Dentistry
  • Columbus, GA
  • NPI 1134495591
  NPD (past) Authorized official

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1063828499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 N STADIUM DR",
            "address_2": "SUITE B",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319091878",
            "telephone_number": "706-225-0444",
            "fax_number": "706-940-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 N STADIUM DR",
            "address_2": "SUITE B",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319091878",
            "telephone_number": "706-225-0444",
            "fax_number": "706-940-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBUS CHILDREN'S DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-07",
        "last_updated": "2014-07-07",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "706-225-0444",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN014428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003145601A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Columbus Cardiology Associates, PC
• Columbus Cardiovascular Surgery, PC
• Columbus Center for Reproductive Endocrinology and Infertility, LLC
• Columbus Center LLC
• Columbus Children's Clinic
• Columbus Clinic PC (Columbus Clinic Specialty Building)
• Columbus Clinic, P.C.
• Columbus Couseling Associates LLC
• Columbus Custom RX, LLC (Columbus Custom Rx Pharmacy: Compounding and Wellness)
• Columbus Department of Public Health

• Pediatric Dentistry in Columbus, GA
• Providers in Columbus, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; 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.