Individual provider Active NPI

Richard Craig Keilson, D.D.S.

  • Pediatric Dentistry
  • Sacramento, CA
National Provider Identifier
1528081452
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DV 031485 Issued in CA
Practice address
103 Scripps Drive
Suite 15
Sacramento, CA 95825
Phone
(916) 929-5534
Fax
(916) 929-7936
NPI assigned
Jul 25, 2006
Sex
Male
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
Pediatric Dentistry 1223P0221X DV 031485 CA Primary

Addresses

Primary practice location

103 Scripps Drive
Suite 15
Sacramento, CA 95825

Mailing address

103 Scripps Dr
Suite 15
Sacramento, CA 95825-6316
Phone (916) 797-0301

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
DV 031485CAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528081452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SCRIPPS DR",
            "address_2": "SUITE 15",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256316",
            "telephone_number": "916-797-0301",
            "fax_number": "916-929-7936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SCRIPPS DRIVE",
            "address_2": "SUITE 15",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95825",
            "telephone_number": "916-929-5534",
            "fax_number": "916-929-7936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEILSON",
        "first_name": "RICHARD",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "DV 031485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

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.