Active NPI
Tracy Beth Keller, RDH, EFDA
- Dental Hygienist
- Sandusky, OH
National Provider Identifier
1770924748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 31008390
- Practice address
- 420 Superior St
Sandusky, OH 44870-1849 - Phone
- (419) 626-5623
- Fax
- (419) 626-8778
- NPI assigned
- Jul 8, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 31008390 | OH | Primary |
Addresses
Primary practice location
420 Superior St
Sandusky, OH 44870-1849
Mailing address
420 Superior St
Sandusky, OH 44870-1849
Phone (419) 626-5623
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31008390 | OH | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373241600000",
"number": "1770924748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 SUPERIOR ST",
"city": "SANDUSKY",
"state": "OH",
"postal_code": "448701849",
"telephone_number": "419-626-5623",
"fax_number": "419-626-8778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 SUPERIOR ST",
"city": "SANDUSKY",
"state": "OH",
"postal_code": "448701849",
"telephone_number": "419-626-5623",
"fax_number": "419-626-8778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLER",
"first_name": "TRACY",
"middle_name": "BETH",
"credential": "RDH, EFDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-08",
"last_updated": "2013-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "OH",
"license": "31008390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandusky, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.