Keep Smiling Dental Group DRS. Roddy & Palm LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

KEEP SMILING DENTAL GROUP DRS. RODDY & PALM LLC

Practice address

4090 Indian Ripple Rd Ste 101
Beavercreek, OH 45440-3292

Phone

(937) 426-5340

NPI assigned

Mar 16, 2021

Last updated

Mar 16, 2021By 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

Sue Rader

Title

Business Manager

Phone

(937) 426-5340

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 2

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.

• Ronald L. Roddy, D.D.S.

  • General Practice Dentistry
  • Beavercreek, OH
  • NPI 1013089770
  NPD
• Joseph Palm

  • General Practice Dentistry
  • Beavercreek, OH
  • NPI 1376034488
  NPD (past)

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1710562251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4090 INDIAN RIPPLE RD STE 101",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454403292",
            "telephone_number": "937-426-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4090 INDIAN RIPPLE RD STE 101",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454403292",
            "telephone_number": "937-426-5340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2355 Lakeview Dr",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454313695",
            "country_code": "US",
            "telephone_number": "937-426-5340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KEEP SMILING DENTAL GROUP DRS. RODDY & PALM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-16",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "RADER",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "937-426-5340"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1013089770",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1376034488",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO STATE DENTAL BOARD",
            "identifier": "30.019043",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO STATE DENTAL BOARD",
            "identifier": "30.025388",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy Katula
• Abi Katz, DO
• Marjorie Wing Kavanaugh, MS
• Jaclyn Marie Kawsky, PHARMD
• Nina Rose Keegan, RN, APRN, BC
• Lisa Collier Kellar, MD
• Brian E Kelley, LMT
• Adrienne Kelly
• Allison Olivia Kelly, PT,DPT
• Ava Jayne Kelly

• Dentist in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.