Individual provider Active NPI

Julie Louise Keilty, D.D.S.

  • Dentist
  • Aurora, IL
National Provider Identifier
1740629468
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019022254 Issued in IL
Practice address
1940 W Galena Blvd
Aurora, IL 60506-4319
Phone
(630) 892-7087
Fax
(630) 892-3722
NPI assigned
Jun 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019022254 IL Primary

Addresses

Primary practice location

1940 W Galena Blvd
Aurora, IL 60506-4319

Mailing address

1940 W Galena Blvd
Aurora, IL 60506-4319
Phone (630) 892-7087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20150428001559 IL Order and Referring Only - DentistPractitioner - Dentist 0840519716

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019022254ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1371254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433376000000",
    "number": "1740629468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 W GALENA BLVD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064319",
            "telephone_number": "630-892-7087",
            "fax_number": "630-892-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 W GALENA BLVD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064319",
            "telephone_number": "630-892-7087",
            "fax_number": "630-892-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEILTY",
        "first_name": "JULIE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-15",
        "last_updated": "2015-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019022254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.