Charles Keefe, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

5137 Issued in CT

Practice address

191 Albany Tpke
Canton, CT 06019-2511

Phone

(860) 693-0887

Fax

(860) 693-1079

NPI assigned

May 3, 2007

Last updated

Oct 25, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Canton Valley Dental LLC

  • General Practice Dentistry
  • Canton, CT
  • NPI 1154560118
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382659200000",
    "number": "1487876272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 ALBANY TPKE",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060192511",
            "telephone_number": "860-693-0887",
            "fax_number": "860-693-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 ALBANY TPKE",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060192511",
            "telephone_number": "860-693-0887",
            "fax_number": "860-693-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFE",
        "first_name": "CHARLES",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2013-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "5137",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "5137",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Bartley Jeffery
• Judy Cabeceiras
• Stephen Karpenko, D.C.
• Jason Kasprzak, D.M.D.
• Elizabeth Kassel, PT
• Matthew Keefe, D.M.D.
• Theresa Keefe, D.M.D.
• Martin W Kidder
• Sandra Jean Kissel, APRN
• John Kouch, M.D.

• Dentist in Canton, CT
• Providers in Canton, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.