Individual provider Active NPI

Connie Keiser, RDH

  • Dental Hygienist
  • Center, CO
National Provider Identifier
1124297510
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
904401 Issued in CO
Practice address
220 S Worth Street
Center, CO 81125
Phone
(719) 754-3584
Fax
(719) 754-2470
NPI assigned
Feb 29, 2008
Last updated
Feb 29, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 904401 CO Primary

Addresses

Primary practice location

220 S Worth Street
Center, CO 81125

Mailing address

128 Market St
Alamosa, CO 81101-2290
Phone (719) 589-5161

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
904401COMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1124297510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 MARKET ST",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012290",
            "telephone_number": "719-589-5161",
            "fax_number": "719-589-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S WORTH STREET",
            "city": "CENTER",
            "state": "CO",
            "postal_code": "81125",
            "telephone_number": "719-754-3584",
            "fax_number": "719-754-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEISER",
        "first_name": "CONNIE",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "904401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Center, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; 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.