Individual provider Active NPI

Brittany Keck-Flory, DMD

  • General Practice Dentistry
  • Mount Zion, IL
National Provider Identifier
1780158998
Registry record updated Mar 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019031588 Issued in IL
Practice address
108 E Ashland Ave
Mount Zion, IL 62549-1271
Phone
(217) 864-2108
NPI assigned
Jan 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2019

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 019031588 IL Primary

Addresses

Primary practice location

108 E Ashland Ave
Mount Zion, IL 62549-1271

Mailing address

108 E Ashland Ave
Mount Zion, IL 62549-1271

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

LicenseStateTypeSpecialty
019031588ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551398400000",
    "number": "1780158998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 E ASHLAND AVE",
            "city": "MOUNT ZION",
            "state": "IL",
            "postal_code": "625491271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 E ASHLAND AVE",
            "city": "MOUNT ZION",
            "state": "IL",
            "postal_code": "625491271",
            "telephone_number": "217-864-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECK-FLORY",
        "first_name": "BRITTANY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019031588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Zion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.