Active NPI
Kyle Geelan, DMD
- Dentist
- Buckeye, AZ
National Provider Identifier
1912381591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D009231
- Practice address
- 26700 S US Highway 85
Aspc Lewis Corizon Health Care
Buckeye, AZ 85326-5024 - Phone
- (623) 386-6160
- NPI assigned
- Jul 14, 2015
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | D009231 | AZ | Primary |
Addresses
Primary practice location
26700 S US Highway 85
Aspc Lewis Corizon Health Care
Buckeye, AZ 85326-5024
Mailing address
26700 S US Highway 85
Aspc Lewis Corizon Health Care
Buckeye, AZ 85326-5024
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170217001357 | OR | Order and Referring Only - Dentist | 9638452626 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D009231 | AZ | MD | Dentist |
Interoperability endpoints
- kgeelan192201@direct.ochin.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440547200000",
"number": "1912381591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26700 S US HIGHWAY 85",
"address_2": "ASPC LEWIS CORIZON HEALTH CARE",
"city": "BUCKEYE",
"state": "AZ",
"postal_code": "853265024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26700 S US HIGHWAY 85",
"address_2": "ASPC LEWIS CORIZON HEALTH CARE",
"city": "BUCKEYE",
"state": "AZ",
"postal_code": "853265024",
"telephone_number": "623-386-6160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEELAN",
"first_name": "KYLE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-14",
"last_updated": "2015-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D009231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Buckeye, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.