Mark N Keilman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7587 Issued in OR

Practice address

421 W 9TH St
The Dalles, OR 97058-1401

Phone

(541) 296-1118

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Practice roles

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.

• Keilman Dental Clinic PC

  • General Practice Dentistry
  • The Dalles, OR
  • NPI 1902841331
  NPD (past) Authorized official

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1144257551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 W 9TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970581401",
            "telephone_number": "541-296-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 W 9TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970581401",
            "telephone_number": "541-296-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEILMAN",
        "first_name": "MARK",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "7587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102673",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Lee Kaatz, LMT
• Dianne Riggs Kaylor, DPT
• Audrey Kearns
• Keilman Dental Clinic PC
• Gregory Leo Keilman, DC
• Daniel Joseph Kelly, MD
• Darlene M Kemper, LPC
• Delese Kendrick, CADC, CGAC
• Kenneth V Miller D.C P.C
• Tiffany Kenslow, MSW

• General Practice Dentistry in The Dalles, OR
• Providers in The Dalles, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.