Ronald John Kehl, DDS
Individual provider Active NPI Dentist · Redway, CA
NPI 1740514645 · NPPES record last updated Mar 5, 2021
Key facts
- NPI
- 1740514645
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 3629539922 (UT)
- Practice address
- 101 West Coast Rd
Redway, CA 95560 - Phone
- (707) 923-2783
- NPI assigned
- Sep 24, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Dentist
- Education
- University of Oklahoma College of Dentistry, 1998
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 939
Angels Camp, CA 95222
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260305000058 | TX | Practitioner - Dentist | 2365924784 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3629539922 | UT | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duchesne County | Current | Accepting new patients | |
| M a C T Health Board Incorporated | Current |
Accepting new patients | |
| M a C T Health Board Incorporated | Current |
Accepting new patients | |
| County of Duchesne | Current | Accepting new patients |
Locations
19177 State Highway 120
Groveland, CA 95321
Phone (209) 754-6262
12150 New York Ranch Rd
Jackson, CA 95642
Phone (209) 223-8460
13975 Mono Way
Ste I
Sonora, CA 95370
Phone (209) 533-9603
Interoperability endpoints
- ronald.kehl.p1@direct.rrhc.nextgenshare.com
- rkehl677367@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 105921 | CA | |
| Dentist | 122300000X | 3629539922 | UT | Yes |
Addresses
Primary practice location
101 West Coast Rd
Redway, CA 95560
Mailing address
PO Box 769
Redway, CA 95560-0769
Phone (707) 923-2783
Other providers in Redway, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.