Active NPI
Kanghyun Keem, DDS
- Dentist
- Bowie, MD
National Provider Identifier
1528582368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 16515
- Practice address
- 6141 High Bridge Rd
Bowie, MD 20720-5216 - Phone
- (301) 801-6404
- Fax
- (301) 262-8609
- NPI assigned
- Aug 2, 2017
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 16515 | MD | Primary |
Addresses
Primary practice location
6141 High Bridge Rd
Bowie, MD 20720-5216
Mailing address
6141 High Bridge Rd
Bowie, MD 20720-5216
Phone (301) 801-6404
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16515 | MD | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neibauer Dental Care, P.C. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Neibauer Dental Care - Bowie
- General Practice Dentistry
- Bowie, MD
- NPI 1285901801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1528582368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6141 HIGH BRIDGE RD",
"city": "BOWIE",
"state": "MD",
"postal_code": "207205216",
"telephone_number": "301-801-6404",
"fax_number": "301-262-8609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6141 HIGH BRIDGE RD",
"city": "BOWIE",
"state": "MD",
"postal_code": "207205216",
"telephone_number": "301-801-6404",
"fax_number": "301-262-8609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEEM",
"first_name": "KANGHYUN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-02",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "16515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.