Active NPI
Trevor Howard Keller, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Catskill, NY
National Provider Identifier
1649360850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 048618
- Practice address
- 159 Jefferson HTS
Suite a-202
Catskill, NY 12414-1237 - Phone
- (518) 943-0780
- Fax
- (518) 943-0783
- NPI assigned
- Oct 16, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 048618 | NY | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 048618 | NY | Primary |
Addresses
Primary practice location
159 Jefferson HTS
Suite a-202
Catskill, NY 12414-1237
Mailing address
159 Jefferson HTS
Suite a-202
Catskill, NY 12414-1237
Phone (518) 943-0780
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02208542 | Medicaid | NY | |
| 10072049 | Other | NY | CDPHP |
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 |
|---|---|---|---|
| 048618 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1649360850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "159 JEFFERSON HTS",
"address_2": "SUITE A-202",
"city": "CATSKILL",
"state": "NY",
"postal_code": "124141237",
"telephone_number": "518-943-0780",
"fax_number": "518-943-0783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "159 JEFFERSON HTS",
"address_2": "SUITE A-202",
"city": "CATSKILL",
"state": "NY",
"postal_code": "124141237",
"telephone_number": "518-943-0780",
"fax_number": "518-943-0783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLER",
"first_name": "TREVOR",
"middle_name": "HOWARD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "048618",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NY",
"license": "048618",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02208542",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP",
"identifier": "10072049",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Catskill, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.