Individual provider Active NPI

Juliette Keller, D.M.D.

  • Pediatric Dentistry
  • Lexington, KY
National Provider Identifier
1922085034
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
5985 Issued in KY
Practice address
740 S Limestone
Lexington, KY 40536
Phone
(859) 323-6261
NPI assigned
Dec 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 5985 KY Primary

Addresses

Primary practice location

740 S Limestone
Lexington, KY 40536

Mailing address

800 Rose St
D104
Lexington, KY 40536-2335
Phone (859) 323-3368

Other identifiers 1

IdentifierTypeStateIssuer
60059854MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20201022000490 KY Practitioner - Dentist 8325468895 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5985KYMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky Pediatric Dentistry CurrentSince Oct 16, 2020 Accepting new patients
University of Kentucky CurrentSince Oct 16, 2020 Accepting new patients

Locations

800 Rose St
#D104
Lexington, KY 40536
Phone (859) 323-3368

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1922085034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "address_2": "D104",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405362335",
            "telephone_number": "859-323-3368",
            "fax_number": "859-257-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40536",
            "telephone_number": "859-323-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JULIETTE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "5985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60059854",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.