Individual provider Active NPI

Keyla Ivette Torres, DMD, MS

  • Periodontics
  • Columbia, MD
National Provider Identifier
1811126261
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2757 Issued in PR
Practice address
6395 Dobbin Rd Ste 208
Columbia, MD 21045-4759
Phone
(410) 997-1189
Fax
(412) 992-5474
NPI assigned
Jul 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 2757 PR Primary

Addresses

Primary practice location

6395 Dobbin Rd Ste 208
Columbia, MD 21045-4759

Mailing address

6395 Dobbin Rd Ste 208
Columbia, MD 21045-4759
Phone (410) 997-1189

Other identifiers 1

IdentifierTypeStateIssuer
2757OtherPRDENTIST LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190826000952 MD Practitioner - Dentist 6800124132 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2757PRMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University Current Accepting new patients
Johns Hopkins University CurrentSince Aug 1, 2019 Accepting new patients
Columbia Center for Implants & Periodontics Periodontics CurrentSince May 3, 2020 Accepting new patients
Johns Hopkins University CurrentSince Aug 1, 2019 Accepting new patients
Johns Hopkins University Past Accepting new patients

Locations

600 N Wolfe St
#266
Baltimore, MD 21287
Phone (410) 502-4340

6395 Dobbin Rd
Ste 208
Columbia, MD 21045
Phone (410) 997-1189

8322 Bellona Ave
Ste 300
Towson, MD 21204
Phone (410) 296-0414

Interoperability endpoints

  • Direct secure messaging: ktorres566005@direct.hopkinsmedicine.org

Organizations & group practices 5

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": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1811126261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6395 DOBBIN RD STE 208",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210454759",
            "telephone_number": "410-997-1189",
            "fax_number": "410-992-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6395 DOBBIN RD STE 208",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210454759",
            "telephone_number": "410-997-1189",
            "fax_number": "412-992-5474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES",
        "first_name": "KEYLA",
        "middle_name": "IVETTE",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-07",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PR",
            "license": "2757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST LICENSE",
            "identifier": "2757",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.