Organization Active NPI

Keller Professional Group, DMD, PC

  • Dentist
  • Saint Louis, MO
National Provider Identifier
1306935986
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
KELLER PROFESSIONAL GROUP, DMD, PC
Practice address
3929 Bayless Ave
Saint Louis, MO 63125-1437
Phone
(314) 638-4190
Fax
(314) 638-3900
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Duane Clay Keller, D.M.D.NPI 1932298502
Title
President
Phone
(314) 638-4190

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

3929 Bayless Ave
Saint Louis, MO 63125-1437

Mailing address

3929 Bayless Ave
Saint Louis, MO 63125-1437
Phone (314) 638-4190

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1306935986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929 BAYLESS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631251437",
            "telephone_number": "314-638-4190",
            "fax_number": "314-638-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3929 BAYLESS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631251437",
            "telephone_number": "314-638-4190",
            "fax_number": "314-638-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLER PROFESSIONAL GROUP, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "DUANE",
        "authorized_official_middle_name": "CLAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-638-4190",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.