Active NPI
Keris Ryan Flynn, DMD
- Dentist
- Fort Hood, TX
National Provider Identifier
1801316773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN1857619
- Practice address
- BLDG 4431, 68TH St
Fort Hood, TX 76544 - Phone
- (254) 287-3105
- NPI assigned
- Jun 22, 2017
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN1857619 | MA | Primary |
Addresses
Primary practice location
BLDG 4431, 68TH St
Fort Hood, TX 76544
Mailing address
601 E 5TH St Apt 1
South Boston, MA 02127-3139
Phone (781) 413-7130
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 |
|---|---|---|---|
| DN1857619 | MA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dod | Dentist | 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": "1498089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498089600000",
"number": "1801316773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 E 5TH ST APT 1",
"city": "SOUTH BOSTON",
"state": "MA",
"postal_code": "021273139",
"telephone_number": "781-413-7130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BLDG 4431, 68TH ST",
"city": "FORT HOOD",
"state": "TX",
"postal_code": "76544",
"telephone_number": "254-287-3105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLYNN",
"first_name": "KERIS",
"middle_name": "RYAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-22",
"last_updated": "2017-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1857619",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Hood, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.