Keith A Dung, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE00006852 Issued in WA

Practice address

11545 15TH Ave NE
Seattle, WA 98125-6358

Phone

(206) 362-5505

Fax

(206) 362-3083

NPI assigned

Dec 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083782791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11545 15TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981256358",
            "telephone_number": "206-362-5505",
            "fax_number": "206-362-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11545 15TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981256358",
            "telephone_number": "206-362-5505",
            "fax_number": "206-362-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNG",
        "first_name": "KEITH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00006852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharonda Lynn Duncan
• Tiana M. Duncan, LMT
• Christine Ann Dunchak, PHYSICAL THERAPIST
• Kelly Dundon, MD
• Diana E Dundore, M.D.
• Elizabeth Mirabai Dunham, M.A., LMFT
• George Dunham
• Gregor Dunham, M.D.
• James T Dunham, DMD
• Sara Kate Dunham, LMHCA

• Dentist in Seattle, WA
• Providers in Seattle, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.