Individual provider Active NPI

Gary Keel, DMD

  • Dentist
  • Anchorage, AK
National Provider Identifier
1710911656
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
990 Issued in AK
Practice address
4201 Tudor Centre Dr
Suite 320
Anchorage, AK 99508-5904
Phone
(907) 317-6070
Fax
(806) 791-1919
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 262091 MI
Dentist 122300000X 990 AK Primary

Addresses

Primary practice location

4201 Tudor Centre Dr
Suite 320
Anchorage, AK 99508-5904

Mailing address

PO Box 196320
Anchorage, AK 99519
Phone (907) 317-6070

Other identifiers 2

IdentifierTypeStateIssuer
1748122OtherUNITED CONCORDIA
DD26201MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151123000239 TX Order and Referring Only - DentistPractitioner - Dentist 9830499961

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
990AKMDDentist
262091MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium Current Accepting new patients
Southcentral Foundation Dental Dhat Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gkeel@direct.scf.cc

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710911656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 196320",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99519",
            "telephone_number": "907-317-6070",
            "fax_number": "806-791-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 TUDOR CENTRE DR",
            "address_2": "SUITE 320",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085904",
            "telephone_number": "907-317-6070",
            "fax_number": "806-791-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEL",
        "first_name": "GARY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "262091",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1748122",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD26201",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.