NPIMap

Organization Active NPI

Da Vinci Dental LLC

Doing business as KALM Dental Spa

  • Dentist
  • Scottsdale, AZ
National Provider Identifier
1346628203
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00011082 Issued in WA
Legal business name
DA VINCI DENTAL LLC
Doing business as
KALM Dental Spa
Practice address
7014 E Camelback Rd
Suite 2145
Scottsdale, AZ 85251-1227
Phone
(480) 500-9999
Fax
(888) 507-5181
NPI assigned
May 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Authorized official

Name
Beau J Keller, DMD
Title
Owner
Phone
(425) 409-9999

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X D009161 AZ
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DE00011082 WA Primary

Addresses

Primary practice location

7014 E Camelback Rd
Suite 2145
Scottsdale, AZ 85251-1227

Mailing address

909 112TH Ave NE
Suite P-104
Bellevue, WA 98004-8580
Phone (425) 409-9999

Other names 1

  • KALM Dental Spa Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Davinci Dental3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7014 E Camelback Rd
Ste 2145
Scottsdale, AZ 85251
Phone (480) 500-9999

909 112th Ave NE
Ste P104
Bellevue, WA 98004
Phone (425) 409-9999

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431388800000",
    "number": "1346628203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 112TH AVE NE",
            "address_2": "SUITE P-104",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980048580",
            "telephone_number": "425-409-9999",
            "fax_number": "888-507-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7014 E CAMELBACK RD",
            "address_2": "SUITE 2145",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852511227",
            "telephone_number": "480-500-9999",
            "fax_number": "888-507-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DA VINCI DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-12",
        "last_updated": "2015-05-12",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "BEAU",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-409-9999",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D009161",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00011082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KALM Dental Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.