Individual provider Active NPI

Andrew J. Keene, DDS

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1225199037
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13902 Issued in TX
Practice address
2621 S Shepherd Dr
Suite 240
Houston, TX 77098-1515
Phone
(713) 529-0120
Fax
(713) 529-6958
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13902 TX Primary

Addresses

Primary practice location

2621 S Shepherd Dr
Suite 240
Houston, TX 77098-1515

Mailing address

2621 S Shepherd Dr
Suite 240
Houston, TX 77098-1515
Phone (713) 529-0120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20160203001601 TX Order and Referring Only - DentistPractitioner - Dentist 0143524645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13902TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225199037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 S SHEPHERD DR",
            "address_2": "SUITE 240",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770981515",
            "telephone_number": "713-529-0120",
            "fax_number": "713-529-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 S SHEPHERD DR",
            "address_2": "SUITE 240",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770981515",
            "telephone_number": "713-529-0120",
            "fax_number": "713-529-6958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENE",
        "first_name": "ANDREW",
        "middle_name": "J.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "13902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.