Keith D Jameson, DDS
Individual provider Active NPI Dentist · Santa Fe, NM
NPI 1801964754 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1801964754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 1408 (NM)
- Practice address
- 4041 Cerrillos Rd
Santa Fe, NM 87507-2916 - Phone
- (505) 438-3276
- Fax
- (505) 474-8201
- NPI assigned
- Nov 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1408 | NM | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ahh Dental | Past |
Accepting new patients | |
| Keith D Jameson DDS PC | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1408 | NM | Yes |
Addresses
Primary practice location
4041 Cerrillos Rd
Santa Fe, NM 87507-2916
Mailing address
4041 Cerrillos Rd
Santa Fe, NM 87507-2916
Phone (505) 438-3276
Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.