Katelyn Keller, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

24389 Issued in FL

Practice address

5037 S Cleveland Ave Ste 102
Fort Myers, FL 33907-1377

Phone

(239) 236-2103

NPI assigned

Aug 31, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Dentists of Fort Myers PA

  • General Practice Dentistry
  • Fort Myers, FL
  • NPI 1598494007
  NPD
• Naples Modern Dentistry, PA

  • Dentist
  • Naples, FL
  • NPI 1215495577
  NPD (past)

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

{
    "created_epoch": "1567209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1306494497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19767 COCONUT HARBOR CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339085078",
            "telephone_number": "814-934-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5037 S CLEVELAND AVE STE 102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071377",
            "telephone_number": "239-236-2103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7430 Immokalee Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341191483",
            "country_code": "US",
            "telephone_number": "239-316-3763",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 W 3rd St",
            "address_purpose": "LOCATION",
            "city": "Lewistown",
            "state": "PA",
            "postal_code": "170441713",
            "country_code": "US",
            "telephone_number": "717-248-6004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLER",
        "first_name": "KATELYN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-31",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS042453",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN24389",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "24389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Owen Wesley Kelchner II
• Christopher Alexander Kelesoglou, MD
• Joni Renee Kellams
• Kelleen M Linden PHD PA
• John Howard Kellenberger Sr., DC
• Nicole W. Keller, PA
• David G Kelley, D.MIN.
• Kenneth Charles Kelley, B.S.
• Linda Kelley, LMHC
• Marcus Kelley, CRNA

• General Practice Dentistry in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.