Keaton Wallace Hughes, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-0006892-C1 Issued in AL

Practice address

7065 Fain Park Dr
Montgomery, AL 36117-7862

Phone

(334) 279-6488

NPI assigned

Jun 14, 2021

Last updated

Jun 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Keaton Larson Wallace Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Teri W Sandlin DDS PC

  • Dentist
  • Montgomery, AL
  • NPI 1205174976

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1730757048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9266 CRESCENT LODGE CIR",
            "city": "PIKE ROAD",
            "state": "AL",
            "postal_code": "360642583",
            "telephone_number": "770-807-5726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7065 FAIN PARK DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177862",
            "telephone_number": "334-279-6488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "KEATON",
        "middle_name": "WALLACE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "D-0006892-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEATON",
            "last_name": "WALLACE",
            "middle_name": "LARSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carol N Huett
• Kyle Daniel Huff, ATC
• Alicia J Hughes, M.D.
• Cody Allen Hughes, DMD
• Emily Hughes, LPC
• Keith Shawn Hughes, MD
• Leslie Ann Hughes, CRNA
• Robert Hughes, CRNA
• Tevin Jermez Hughley, DO
• Hughston Clinic PC

• General Practice Dentistry in Montgomery, AL
• Providers in Montgomery, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.