Individual provider Active NPI

Kevin Michael Keating, D.D.S., M.S.

  • Endodontics
  • Sacramento, CA
National Provider Identifier
1134258973
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
27005 Issued in CA
Practice address
1810 Professional Dr
Suite a
Sacramento, CA 95825-2165
Phone
(916) 485-6900
Fax
(916) 485-0102
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 27005 CA Primary

Addresses

Primary practice location

1810 Professional Dr
Suite a
Sacramento, CA 95825-2165

Mailing address

1810 Professional Dr
Suite a
Sacramento, CA 95825-2165
Phone (916) 485-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20160107002574 CA Order and Referring Only - DentistPractitioner - Dentist 2668774662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Whitnack, Keating, Greene & Bal, a Dental Corporation Endodontics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134258973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 PROFESSIONAL DR",
            "address_2": "SUITE A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252165",
            "telephone_number": "916-485-6900",
            "fax_number": "916-485-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 PROFESSIONAL DR",
            "address_2": "SUITE A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252165",
            "telephone_number": "916-485-6900",
            "fax_number": "916-485-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEATING",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "27005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.