Individual provider Active NPI

Jayne Keller, DMD

  • General Practice Dentistry
  • Chambersburg, PA
National Provider Identifier
1497838734
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS-024880-L Issued in PA
Practice address
475 Phoenix Dr
Chambersburg, PA 17201-4534
Phone
(717) 267-2059
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS-024880-L PA Primary

Addresses

Primary practice location

475 Phoenix Dr
Chambersburg, PA 17201-4534

Mailing address

475 Phoenix Dr
Chambersburg, PA 17201-4534
Phone (717) 267-2059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS-024880-LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Dental Care, LLC General Practice CurrentSince Feb 2, 2020 Accepting new patients

Locations

475 Phoenix Dr
Chambersburg, PA 17201
Phone (717) 267-2059

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497838734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 PHOENIX DR",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014534",
            "telephone_number": "717-267-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 PHOENIX DR",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014534",
            "telephone_number": "717-267-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JAYNE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-024880-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chambersburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.