Gary Keeler DDS, Oral Maxillofacial Surgery LLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

GARY KEELER DDS, ORAL MAXILLOFACIAL SURGERY LLC

Doing business as

Gary Keeler DDS, Oral Maxillofacial Surgery LLC

Practice address

1000 Lakeland Square Ext Ste 700
Flowood, MS 39232-7648

Phone

(601) 936-3555

Fax

(601) 936-3580

NPI assigned

Jul 17, 2012

Last updated

Nov 8, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gary Keeler, D.D.S.NPI 1285815589

Title

Owner/Manager

Phone

(601) 936-3555

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Gary Keeler DDS, Oral Maxillofacial Surgery LLC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gary Demetrick Keeler, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Alcoa, TN
  • NPI 1285815589
  NPD Authorized official

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541635200000",
    "number": "1659626448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 E COUNTY LINE RD STE 3A-213",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571900",
            "telephone_number": "601-936-3555",
            "fax_number": "601-936-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LAKELAND SQUARE EXT STE 700",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327648",
            "telephone_number": "601-936-3555",
            "fax_number": "601-936-3580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "514G E. Woodrow Wilson Drive",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "39216",
            "country_code": "US",
            "telephone_number": "601-487-6243",
            "fax_number": "601-487-6310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GARY KEELER DDS, ORAL MAXILLOFACIAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-17",
        "last_updated": "2018-11-08",
        "status": "A",
        "authorized_official_last_name": "KEELER",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "601-936-3555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MS",
            "license": "347808",
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01880393",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gary Keeler DDS, Oral Maxillofacial Surgery LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gary Keeler DDS, Oral Maxillofacial Surgery LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katlyn Dianne Garner, DPT
• Garrett Family Chiropractic LLC
• Dorothea A Garrett, LPC
• Thomas Albert Garrett, D.C.
• Danon Eugenio Garrido Montes de Oca, MD
• Lee D Gary, D.M.D
• Gastrointestinal Associates Endoscopy Center, LLC
• Gastrointestinal Associates, P.a.
• Gastrointestinal Associates, PA
• Gastrointestinal Associates, PA (GIA Gardens Rx)

• Oral and Maxillofacial Surgery Clinic/Center in Flowood, MS
• Providers in Flowood, MS by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.