Active NPI
Phanith D Keo, DMD
- Dentist
- Sarasota, FL
National Provider Identifier
1285828491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN 18543
- Practice address
- 7317 N Tamiami TRL
Sarasota, FL 34243-1402 - Phone
- (941) 306-5884
- NPI assigned
- Aug 30, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 21983 | MA | |
| Dentist | 122300000X | DN 18543 | FL | Primary |
Addresses
Primary practice location
7317 N Tamiami TRL
Sarasota, FL 34243-1402
Mailing address
7317 N Tamiami TRL
Sarasota, FL 34243-1402
Phone (941) 306-5884
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 18543 | FL | MD | Dentist |
| 21983 | MA | MD | Dentist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372291200000",
"number": "1285828491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7317 N TAMIAMI TRL",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342431402",
"telephone_number": "941-306-5884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7317 N TAMIAMI TRL",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342431402",
"telephone_number": "941-306-5884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEO",
"first_name": "PHANITH",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-30",
"last_updated": "2013-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "21983",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN 18543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.