Individual provider Active NPI

Keith Trevor Paskett, DMD, MD, MBA

  • Oral and Maxillofacial Surgery (Dentist)
  • Edmond, OK
National Provider Identifier
1649777343
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
245 Issued in OK
Practice address
18001 N Western Ave Ste 106
Edmond, OK 73012-9135
Phone
(405) 256-3446
NPI assigned
Apr 9, 2018
Last updated
Jan 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 245 OK Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2025000173 MO

Addresses

Primary practice location

18001 N Western Ave Ste 106
Edmond, OK 73012-9135

Mailing address

18001 N Western Ave Ste 106
Edmond, OK 73012-9135
Phone (405) 256-3446

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
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2025000173MOMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1649777343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18001 N WESTERN AVE STE 106",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730129135",
            "telephone_number": "405-256-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18001 N WESTERN AVE STE 106",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730129135",
            "telephone_number": "405-256-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASKETT",
        "first_name": "KEITH",
        "middle_name": "TREVOR",
        "name_prefix": "Dr.",
        "credential": "DMD, MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "245",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "2025000173",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.

Verify at the official NPI Registry.