Individual provider Active NPI

Steven C Keeton, DDS

  • Public Health Dentistry
  • Knoxville, TN
National Provider Identifier
1073516902
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
DS3794 Issued in TN
Practice address
140 Dameron Ave
Knoxville, TN 37917-6413
Phone
(865) 215-5163
Fax
(865) 215-5295
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X DS3794 TN Primary

Addresses

Primary practice location

140 Dameron Ave
Knoxville, TN 37917-6413

Mailing address

9121 British Station LN
Knoxville, TN 37922-9468
Phone (865) 690-6651

Other identifiers 1

IdentifierTypeStateIssuer
5440564MedicaidTN

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

LicenseStateTypeSpecialty
DS3794TNMDPublic Health Dentist

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1073516902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9121 BRITISH STATION LN",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379229468",
            "telephone_number": "865-690-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 DAMERON AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379176413",
            "telephone_number": "865-215-5163",
            "fax_number": "865-215-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEETON",
        "first_name": "STEVEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "TN",
            "license": "DS3794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5440564",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.