Active NPI
John F Keohan, DDS
- Dentist
- Cambridge, MA
National Provider Identifier
1588783252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10909
- Practice address
- 310 Cambridge St
Cambridge, MA 02141-1203 - Phone
- (617) 876-7238
- Fax
- (617) 868-8650
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 10909 | MA | Primary |
Addresses
Primary practice location
310 Cambridge St
Cambridge, MA 02141-1203
Mailing address
310 Cambridge St
Cambridge, MA 02141-1203
Phone (617) 876-7238
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 |
|---|---|---|---|
| 10909 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1588783252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 CAMBRIDGE ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021411203",
"telephone_number": "617-876-7238",
"fax_number": "617-868-8650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 CAMBRIDGE ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021411203",
"telephone_number": "617-876-7238",
"fax_number": "617-868-8650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEOHAN",
"first_name": "JOHN",
"middle_name": "F",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "10909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
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.