Keely E Long, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34079 Issued in TX

Practice address

8338 N Loop 1604 W Ste 104
San Antonio, TX 78249-3482

Phone

(210) 465-1153

NPI assigned

Jun 26, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1629563291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E CEVALLOS APT 443",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782041979",
            "telephone_number": "469-878-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8338 N LOOP 1604 W STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782493482",
            "telephone_number": "210-465-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KEELY",
        "middle_name": "E",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Parker Long
• Elizabeth Rae Long, APRN-CNS
• Gaylene A Long, RN, CNS
• Heather Leigh Long, LBSW
• Jon Long, RN
• Lea Long
• Loretta Marie Long, LMT
• Michael Long, RN
• Pamella Long, LMT
• Richard David Long, PTA

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.