NPIMap

Organization Active NPI

Duongvannak Keo, DMD

  • Dentist
  • Merritt Island, FL
National Provider Identifier
1154614758
Registry record updated May 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN 13955 Issued in FL
Legal business name
DUONGVANNAK KEO, DMD
Practice address
295 S. Plumosa
Merritt Island, FL 32952
Phone
(321) 452-6000
Fax
(321) 453-8823
NPI assigned
May 16, 2011
Last updated
May 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2011

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

Authorized official

Name
Duongvannak JB Keo, D.M.D. C.A.G.S.NPI 1861571556
Title
Dentist
Phone
(321) 452-6000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN 13955 FL Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN 19124 FL

Addresses

Primary practice location

295 S. Plumosa
Merritt Island, FL 32952

Mailing address

295 S. Plumosa
Merritt Island, FL 32952
Phone (321) 452-6000

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305504000000",
    "number": "1154614758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 S. PLUMOSA",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "32952",
            "telephone_number": "321-452-6000",
            "fax_number": "321-453-8823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 S. PLUMOSA",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "32952",
            "telephone_number": "321-452-6000",
            "fax_number": "321-453-8823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUONGVANNAK KEO, DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-16",
        "last_updated": "2011-05-16",
        "status": "A",
        "authorized_official_last_name": "KEO",
        "authorized_official_first_name": "DUONGVANNAK",
        "authorized_official_middle_name": "JB",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "321-452-6000",
        "authorized_official_credential": "D.M.D. C.A.G.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 13955",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 19124",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; 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.