Duane Clay Keller, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

12581 Issued in MO

Practice address

3929 Bayless Ave
Saint Louis, MO 63125-1437

Phone

(314) 638-4190

Fax

(314) 638-3900

NPI assigned

Oct 12, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2010 through Apr 1, 2028

Medicare enrollment (NPD)

Not enrolled

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.

• Keller Professional Group, DMD, PC

  • Dentist
  • Saint Louis, MO
  • NPI 1306935986
  NPD (past) Authorized official
• Missouri Dental Professionals, Richard Straus, D.M.D., P.C.

  • General Practice Dentistry
  • Saint Louis, MO
  • NPI 1417575119
  NPD (past)
• Missouri Dental Professionals, Richard Straus, DMD, PC

  • General Practice Dentistry
  • Columbia, MO
  • NPI 1558669556
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932298502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929 BAYLESS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631251437",
            "telephone_number": "314-638-4190",
            "fax_number": "314-638-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3929 BAYLESS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631251437",
            "telephone_number": "314-638-4190",
            "fax_number": "314-638-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "DUANE",
        "middle_name": "CLAY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "12581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth Kellenberger, P.T.
• Keller Professional Group, DMD, PC
• Angela Prost Keller, FNP
• Brittney Keller
• Danielle Keller
• James Patrick Keller, LMSW
• Jennifer Keller, M.D.
• Jesse Wade Keller, MD
• Justine Keller, MD
• Madeline Louise Keller, FNP-C

• Dentist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.