Active NPI
Keith Earl January Jr., MS, DMD
- Dentist
- Bastrop, LA
National Provider Identifier
1699419150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7359
- Practice address
- 314 N Franklin St
Bastrop, LA 71220-3846 - Phone
- (318) 283-8887
- Fax
- (318) 281-6339
- NPI assigned
- Apr 21, 2022
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 7359 | LA | Primary |
Addresses
Primary practice location
314 N Franklin St
Bastrop, LA 71220-3846
Mailing address
PO Box 792
Bastrop, LA 71221-0792
Phone (318) 283-8887
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1873594 | Medicaid | LA |
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7359 | LA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Morehouse Community Medical Centers, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba CommuniHealth Services Miller Roy Clinic
- Federally Qualified Health Center (FQHC)
- Monroe, LA
- NPI 1114740438
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742428800000",
"number": "1699419150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 792",
"city": "BASTROP",
"state": "LA",
"postal_code": "712210792",
"telephone_number": "318-283-8887",
"fax_number": "318-281-2559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 N FRANKLIN ST",
"city": "BASTROP",
"state": "LA",
"postal_code": "712203846",
"telephone_number": "318-283-8887",
"fax_number": "318-281-6339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANUARY",
"first_name": "KEITH",
"middle_name": "EARL",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MS, DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-21",
"last_updated": "2025-03-20",
"certification_date": "2025-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "7359",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1873594",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bastrop, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.