Robert J Keck, D.D.S., M.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D8332 Issued in MN

Practice address

3950 Veterans Dr
Suite 100
Saint Cloud, MN 56303-3410

Phone

(320) 252-3611

Fax

(320) 252-7574

NPI assigned

Jun 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Centrasota Oral & Maxillofacial Surgeons, P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Saint Cloud, MN
  • NPI 1598710477
  NPD (past) Authorized official
• Hennepin Faculty Associates

  • General Practice Physician
  • Minneapolis, MN
  • NPI 1063459485
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1902843683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 VETERANS DR",
            "address_2": "SUITE 100",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563033410",
            "telephone_number": "320-252-3611",
            "fax_number": "320-252-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 VETERANS DR",
            "address_2": "SUITE 100",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563033410",
            "telephone_number": "320-252-3611",
            "fax_number": "320-252-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECK",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "D8332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242820200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Kearney, PHD, LP
• Maria Kearney, PHD, LP
• Erin Keating
• Mary U Keating, MD
• Winfridah M Kebaso
• Amanda Lynn Kedrowski
• Danielle Kedrowski
• Haley Kedrowski, PT, DPT
• Shani Kedrowski
• Mary Lynn Keeler

• Oral and Maxillofacial Surgery (Dentist) in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; 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.