Individual provider Active NPI

Kyle Geelan, DMD

  • Dentist
  • Buckeye, AZ
National Provider Identifier
1912381591
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D009231 Issued in AZ
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

Updated by the provider on Aug 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170217001357 OR Order and Referring Only - DentistPractitioner - Dentist 9638452626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D009231AZMDDentist

Interoperability endpoints

  • Direct secure messaging: 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

Verify at the official NPI Registry.