Shannon Keyes DMD LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DIO2191700 Issued in NJ

Legal business name

SHANNON KEYES DMD LLC

Practice address

34 Manchester Ave
Suite 204
Forked River, NJ 08731-1366

Phone

(609) 971-7900

Fax

(609) 971-7799

NPI assigned

Oct 20, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Shannon M Keyes, DMDNPI 1285852871

Title

Dentist

Phone

(609) 971-7900

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Shannon Marie Keyes, DMD

  • General Practice Dentistry
  • Forked River, NJ
  • NPI 1285852871
  NPD (past) Authorized official

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

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413763200000",
    "number": "1235533241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 MANCHESTER AVE",
            "address_2": "SUITE 204",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087311366",
            "telephone_number": "609-971-7900",
            "fax_number": "609-971-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 MANCHESTER AVE",
            "address_2": "SUITE 204",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087311366",
            "telephone_number": "609-971-7900",
            "fax_number": "609-971-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON KEYES DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-20",
        "last_updated": "2014-10-20",
        "status": "A",
        "authorized_official_last_name": "KEYES",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "609-971-7900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DIO2191700",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "22DIO101150701",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Forked River, NJ
• Providers in Forked River, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; 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.