NPIMap

Organization Active NPI

Keith Gjebre DMD LLC

  • Pediatric Dentistry
  • Greensburg, PA
National Provider Identifier
1487732913
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DS023867L Issued in PA
Legal business name
KEITH GJEBRE DMD LLC
Practice address
510 Pellis Road
Suite 102
Greensburg, PA 15601
Phone
(724) 832-2255
Fax
(724) 832-9456
NPI assigned
Nov 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Keith Gjebre, DMC LLCNPI 1740368273
Title
Owner
Phone
(724) 832-2255

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X DS023867L PA Primary

Addresses

Primary practice location

510 Pellis Road
Suite 102
Greensburg, PA 15601

Mailing address

510 Pellis Road
Suite 102
Greensburg, PA 15601
Phone (724) 832-2255

Other names 1

  • Keith Gjebre DMD Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487732913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 PELLIS ROAD",
            "address_2": "SUITE 102",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "15601",
            "telephone_number": "724-832-2255",
            "fax_number": "724-832-9456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 PELLIS ROAD",
            "address_2": "SUITE 102",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "15601",
            "telephone_number": "724-832-2255",
            "fax_number": "724-832-9456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH GJEBRE DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GJEBRE",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-832-2255",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMC LLC"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS023867L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keith Gjebre DMD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Greensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.