Keith Rey Redd, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5610 Issued in WA

Practice address

930 Park Ave
Bremerton, WA 98337

Phone

(360) 377-7621

Fax

(360) 377-6465

NPI assigned

Aug 31, 2006

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 WA

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

Practice roles

Interoperability endpoints

• Direct secure messaging: keith.redd.1@13902.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Russell DDS PC

  • General Practice Dentistry
  • Bremerton, WA
  • NPI 1104249465
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225929600000",
    "number": "1275645996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 PARK AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "98337",
            "telephone_number": "360-377-7621",
            "fax_number": "360-377-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 PARK AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "98337",
            "telephone_number": "360-377-7621",
            "fax_number": "360-377-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDD",
        "first_name": "KEITH",
        "middle_name": "REY",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "5610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca McCann Lactation, LLC
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• Recapturing Dreams Counseling
• Katherine Lauren Recitis, PTA
• Amy Redal
• Shane Ray Reece, IDC
• Joshua Reed
• Sarah Marie Reed
• William H Reed, MD
• Destiny Reedom

• Dentist in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; 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.