Active NPI
Kelly Keefer, DMD
- Dentist
- Manassas, VA
National Provider Identifier
1659625143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401413738
- Practice address
- 8404 Dorsey Cir
Manassas, VA 20110-4592 - Phone
- (703) 330-5755
- NPI assigned
- Nov 5, 2012
- Last updated
- Nov 5, 2012
- Sex
- Female
- 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 | 0401413738 | VA | Primary |
Addresses
Primary practice location
8404 Dorsey Cir
Manassas, VA 20110-4592
Mailing address
8404 Dorsey Cir
Manassas, VA 20110-4592
Phone (703) 330-5755
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 |
|---|---|---|---|
| 0401413738 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352073600000",
"number": "1659625143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8404 DORSEY CIR",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201104592",
"telephone_number": "703-330-5755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8404 DORSEY CIR",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201104592",
"telephone_number": "703-330-5755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEEFER",
"first_name": "KELLY",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-05",
"last_updated": "2012-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401413738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manassas, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.