Keith V Nelson DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

62277 Issued in CA

Legal business name

KEITH V NELSON DDS PC

Practice address

15022 Mulberry Dr
#F
Whittier, CA 90604-4445

Phone

(801) 556-8917

Fax

(801) 618-3913

NPI assigned

Apr 15, 2013

Last updated

Apr 15, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Keith V Nelson, DDS

Title

President

Phone

(801) 556-8917

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365984000000",
    "number": "1265875777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21163 NEWPORT COAST DR",
            "address_2": "STE 211",
            "city": "NEWPORT COAST",
            "state": "CA",
            "postal_code": "926571123",
            "telephone_number": "801-556-8917",
            "fax_number": "801-618-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15022 MULBERRY DR",
            "address_2": "#F",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906044445",
            "telephone_number": "801-556-8917",
            "fax_number": "801-618-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH V NELSON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-15",
        "last_updated": "2013-04-15",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-556-8917",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Whittier, CA
• Providers in Whittier, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; 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.