Charles Michael Keane, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE 12803 Issued in MN

Practice address

315 McHugh Blvd
Commanding Officer 2D Denbn/NDC PSC Box 20130
Camp Lejeune, NC 28542-0130

Phone

(910) 451-2208

Fax

(910) 451-8036

NPI assigned

Sep 9, 2010

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 WI

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

State licenses

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1245547488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MCHUGH BLVD",
            "address_2": "COMMANDING OFFICER 2D DENBN/NDC PSC BOSX 20130",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420130",
            "telephone_number": "910-451-2208",
            "fax_number": "910-451-8036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MCHUGH BLVD",
            "address_2": "COMMANDING OFFICER 2D DENBN/NDC PSC BOX 20130",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420130",
            "telephone_number": "910-451-2208",
            "fax_number": "910-451-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEANE",
        "first_name": "CHARLES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "DE 12803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaime H Kapur, M.D.
• Keith Karnes
• Pamela Boyer Kasten, NP
• Danielle Kato
• Katy L Kazel, M.D.
• Luke Lance Keene, SOIDC
• Thomas Edward Keeton III, SOIDC
• Vilas Joseph Keith, DAOM, L.AC.
• Daniel Keller, MD
• Tyler Scott Kemerer, DDS, MS

• Dentist in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.