Active NPI
Gary G. Keener, D.D.S., P.A.
- General Practice Dentistry
- Sherwood, AR
National Provider Identifier
1861584781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2233
- Practice address
- 9509 Highway 107
Sherwood, AR 72120-2634 - Phone
- (501) 835-4655
- Fax
- (501) 835-4658
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 2233 | AR | Primary |
Addresses
Primary practice location
9509 Highway 107
Sherwood, AR 72120-2634
Mailing address
9509 Highway 107
Sherwood, AR 72120-2634
Phone (501) 835-4655
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 824306 | Other | AR | BLUE CROSS BLUE SHIELD |
| 58905 | Other | AR | FEDERAL BLUE CROSS |
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2233 | AR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gary G. Keener DDS, PA | General Practice | 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.
-
- General Practice Dentistry
- Sherwood, AR
- NPI 1306009741
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861584781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9509 HIGHWAY 107",
"city": "SHERWOOD",
"state": "AR",
"postal_code": "721202634",
"telephone_number": "501-835-4655",
"fax_number": "501-835-4658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9509 HIGHWAY 107",
"city": "SHERWOOD",
"state": "AR",
"postal_code": "721202634",
"telephone_number": "501-835-4655",
"fax_number": "501-835-4658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEENER",
"first_name": "GARY",
"middle_name": "G.",
"name_prefix": "Dr.",
"credential": "D.D.S., P.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "2233",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "824306",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL BLUE CROSS",
"identifier": "58905",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sherwood, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.