Jessica Giovana Keyo, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

107878 Issued in CA

Practice address

6745 Woodman Ave
Valley Glen, CA 91401-1024

Phone

(818) 786-3601

Fax

(818) 786-3601

NPI assigned

Aug 31, 2022

Last updated

Aug 31, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Giovana Ortega Hernandez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1881314797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 E MOUNTAIN ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912071837",
            "telephone_number": "818-303-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6745 WOODMAN AVE",
            "city": "VALLEY GLEN",
            "state": "CA",
            "postal_code": "914011024",
            "telephone_number": "818-786-3601",
            "fax_number": "818-786-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYO",
        "first_name": "JESSICA GIOVANA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "107878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA GIOVANA",
            "last_name": "ORTEGA HERNANDEZ",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dentist in Valley Glen, CA
• Providers in Valley Glen, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.