John Jason Keating III, DMD
Individual provider Active NPI Dentist · Absecon, NJ
NPI 1255459178 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1255459178
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 12247 (NJ)
- Practice address
- 529 New Jersey Ave
Absecon, NJ 08201-2435 - Phone
- (609) 645-3311
- Fax
- (609) 645-2001
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12247 | NJ | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12247 | NJ | Yes |
Addresses
Primary practice location
529 New Jersey Ave
Absecon, NJ 08201-2435
Mailing address
529 New Jersey Ave
Absecon, NJ 08201-2435
Phone (609) 645-3311
Other providers in Absecon, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.