Individual provider Active NPI

Gary Stephen Key, DDS,MS

  • Periodontics
  • Shreveport, LA
National Provider Identifier
1083702153
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2991 Issued in LA
Practice address
2433 E 70TH St
Suite a
Shreveport, LA 71105-4701
Phone
(318) 797-0643
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 2991 LA Primary

Addresses

Primary practice location

2433 E 70TH St
Suite a
Shreveport, LA 71105-4701

Mailing address

2433 E 70TH St
Suite a
Shreveport, LA 71105-4701
Phone (318) 797-0643

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2991LAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1083702153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2433 E 70TH ST",
            "address_2": "SUITE A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054701",
            "telephone_number": "318-797-0643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2433 E 70TH ST",
            "address_2": "SUITE A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054701",
            "telephone_number": "318-797-0643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEY",
        "first_name": "GARY",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DDS,MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "LA",
            "license": "2991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.