Individual provider Active NPI

Dennis Michael Keller, DMD

  • General Practice Dentistry
  • Parlin, NJ
National Provider Identifier
1750405791
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI00985902 Issued in NJ
Practice address
236 Ernston Rd
Suite 6
Parlin, NJ 08859-1926
Phone
(732) 525-0049
Fax
(732) 525-0089
NPI assigned
Mar 16, 2007
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI00985902 NJ Primary

Addresses

Primary practice location

236 Ernston Rd
Suite 6
Parlin, NJ 08859-1926

Mailing address

38 Mercury Cir
South Amboy, NJ 08879-2413
Phone (732) 721-6420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20150609000601 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8820319346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI00985902NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
K&W Family Dental, LLC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750405791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 MERCURY CIR",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088792413",
            "telephone_number": "732-721-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 ERNSTON RD",
            "address_2": "SUITE 6",
            "city": "PARLIN",
            "state": "NJ",
            "postal_code": "088591926",
            "telephone_number": "732-525-0049",
            "fax_number": "732-525-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "DENNIS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI00985902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parlin, NJ

Sources for this page

Verify at the official NPI Registry.