Active NPI
Jessica Bree Geurkink, DDS
- Dentist
- Keller, TX
National Provider Identifier
1154851863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 32983
- Practice address
- 123 Keller Pkwy Ste 100
Keller, TX 76248-2279 - Phone
- (501) 448-0032
- Fax
- (501) 448-0068
- NPI assigned
- Jun 14, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 32983 | TX | Primary |
Addresses
Primary practice location
123 Keller Pkwy Ste 100
Keller, TX 76248-2279
Mailing address
625 Parkview Dr
Roanoke, TX 76262-4201
Phone (817) 491-1900
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
| License | State | Type | Specialty |
|---|---|---|---|
| 32983 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721606400000",
"number": "1154851863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 PARKVIEW DR",
"city": "ROANOKE",
"state": "TX",
"postal_code": "762624201",
"telephone_number": "817-491-1900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 KELLER PKWY STE 100",
"city": "KELLER",
"state": "TX",
"postal_code": "762482279",
"telephone_number": "501-448-0032",
"fax_number": "501-448-0068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEURKINK",
"first_name": "JESSICA",
"middle_name": "BREE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-14",
"last_updated": "2024-07-22",
"certification_date": "2024-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "32983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keller, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.