Individual provider Active NPI

Ronald John Kehl, DDS

  • Dentist
  • Redway, CA
National Provider Identifier
1740514645
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3629539922 Issued in UT
Practice address
101 West Coast Rd
Redway, CA 95560
Phone
(707) 923-2783
NPI assigned
Sep 24, 2009
Last updated
Mar 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 105921 CA
Dentist 122300000X 3629539922 UT Primary

Addresses

Primary practice location

101 West Coast Rd
Redway, CA 95560

Mailing address

PO Box 769
Redway, CA 95560-0769
Phone (707) 923-2783

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
I20260305000058 TX Practitioner - Dentist 2365924784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105921CAMDDentist
3629539922UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
M a C T Health Board Incorporated CurrentSince Mar 2, 2026 Accepting new patients
M a C T Health Board Incorporated CurrentSince Mar 2, 2026 Accepting new patients
County of Duchesne Current Accepting new patients
Duchesne County 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) 257-2400

13975 Mono Way
Ste I
Sonora, CA 95370
Phone (209) 533-9603

Interoperability endpoints

  • Direct secure messaging: rkehl677367@direct.ochin.org
  • Direct secure messaging: ronald.kehl.p1@direct.rrhc.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1740514645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 769",
            "city": "REDWAY",
            "state": "CA",
            "postal_code": "955600769",
            "telephone_number": "707-923-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WEST COAST RD",
            "city": "REDWAY",
            "state": "CA",
            "postal_code": "95560",
            "telephone_number": "707-923-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEHL",
        "first_name": "RONALD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-24",
        "last_updated": "2021-03-05",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105921",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "3629539922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redway, CA

Sources for this page

Verify at the official NPI Registry.