Myron Kellner, D.D.S.,P.A.

Primary specialty

DentistTaxonomy code 122300000X

License

4892 Issued in MD

Practice address

2324 W Joppa Rd
Suite 110
Lutherville, MD 21093-4615

Phone

(410) 321-1100

Fax

(410) 321-8376

NPI assigned

Nov 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184799819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 BRIDLE RDG",
            "city": "STEVENSON",
            "state": "MD",
            "postal_code": "211532032",
            "telephone_number": "410-484-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 W JOPPA RD",
            "address_2": "SUITE 110",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210934615",
            "telephone_number": "410-321-1100",
            "fax_number": "410-321-8376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLNER",
        "first_name": "MYRON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.,P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "4892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyla Keefe
• Keep It Simple Services LLC
• Melissa Kehl
• Sara C Keller, MD
• Marye Kellermann, CRNP
• Maureen L Kelly
• Kevin Terry DPM
• Kristin Lee Khan, MD
• Nagi Khouri, M.D.
• Olla Khoury, PHARM-D

• Dentist in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.