Randall S. Keller, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

38698 Issued in CA

Practice address

250 N Robertson Blvd
Suite 401
Beverly Hills, CA 90211-1788

Phone

(310) 275-4491

Fax

(310) 275-4738

NPI assigned

May 2, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Balaze Dental Group

  • Dental Clinic/Center
  • Beverly Hills, CA
  • NPI 1477396851
  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205058245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N ROBERTSON BLVD",
            "address_2": "SUITE 401",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111788",
            "telephone_number": "310-275-4491",
            "fax_number": "310-275-4738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N ROBERTSON BLVD",
            "address_2": "SUITE 401",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111788",
            "telephone_number": "310-275-4491",
            "fax_number": "310-275-4738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "RANDALL",
        "middle_name": "S.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "38698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE NUMBER",
            "identifier": "38698",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ismail Ebrahim Keekeebhai
• David S Keen, D.D.S., M.S.
• Keihani Dental Corporation
• Keith L Klein MD Facp Fasn Inc
• Keivan Golchini, MD Inc.
• David M Kelley, M.D.
• Kathleen M Kelly, MA, CCC-SLP
• Kimberly Ann Kelly, ND, RD
• Joseph Naylor Kenan, M.D.
• Violetta Kenigsberg, D.D.S

• Dentist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Dentist in California

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.