NPIMap

Organization Active NPI

R. L. Keller DDS & Daniel F. Burk DDS

  • General Practice Dentistry
  • Antioch, CA
National Provider Identifier
1174906887
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0516788 Issued in CA
Legal business name
R. L. KELLER DDS & DANIEL F. BURK DDS
Practice address
3107 Lone Tree Way
Suite a
Antioch, CA 94509-4980
Phone
(925) 757-5081
Fax
(925) 757-4979
NPI assigned
Jun 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Authorized official

Name
Ms. Kenda Sappington
Title
Office Manager
Phone
(925) 757-5081

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 0516788 CA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 29021 CA

Addresses

Primary practice location

3107 Lone Tree Way
Suite a
Antioch, CA 94509-4980

Mailing address

3107 Lone Tree Way
Suite a
Antioch, CA 94509-4980
Phone (925) 757-5081

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1174906887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 LONE TREE WAY",
            "address_2": "SUITE A",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945094980",
            "telephone_number": "925-757-5081",
            "fax_number": "925-757-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107 LONE TREE WAY",
            "address_2": "SUITE A",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945094980",
            "telephone_number": "925-757-5081",
            "fax_number": "925-757-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R. L. KELLER DDS & DANIEL F. BURK DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-30",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "SAPPINGTON",
        "authorized_official_first_name": "KENDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "925-757-5081",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "0516788",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29021",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.