Active NPI
Keven R. Mills, D.D.S.
- General Practice Dentistry
- Granite Bay, CA
National Provider Identifier
1790764421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- CA 35206
- Practice address
- 6910 Douglas Blvd
Suite B
Granite Bay, CA 95746-6276 - Phone
- (916) 791-7227
- Fax
- (916) 791-7487
- NPI assigned
- Jan 11, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | CA 35206 | CA | Primary |
Addresses
Primary practice location
6910 Douglas Blvd
Suite B
Granite Bay, CA 95746-6276
Mailing address
4030 Haviland Dr
Granite Bay, CA 95746-6442
Phone (916) 791-8673
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35206 | CA | MD | Marriage & Family Therapist |
| CA 35206 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1790764421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4030 HAVILAND DR",
"city": "GRANITE BAY",
"state": "CA",
"postal_code": "957466442",
"telephone_number": "916-791-8673",
"fax_number": "916-791-7487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6910 DOUGLAS BLVD",
"address_2": "SUITE B",
"city": "GRANITE BAY",
"state": "CA",
"postal_code": "957466276",
"telephone_number": "916-791-7227",
"fax_number": "916-791-7487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLS",
"first_name": "KEVEN",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-11",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "CA 35206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granite Bay, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.