Individual provider Active NPI

Amelia O'Keefe, DMD

  • General Practice Dentistry
  • North Las Vegas, NV
National Provider Identifier
1962112144
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7746 Issued in NV
Practice address
640 E Deer Springs Way Ste 180
North Las Vegas, NV 89086-1514
Phone
(023) 993-8007
NPI assigned
Nov 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7746 NV Primary

Addresses

Primary practice location

640 E Deer Springs Way Ste 180
North Las Vegas, NV 89086-1514

Mailing address

1015 Edgestone Mark Ave
North Las Vegas, NV 89081-3043
Phone (702) 278-5625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20240524002971 NV Order and Referring Only - DentistPractitioner - Dentist 7719329556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7746NVMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1669680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1962112144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 EDGESTONE MARK AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890813043",
            "telephone_number": "702-278-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E DEER SPRINGS WAY STE 180",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890861514",
            "telephone_number": "023-993-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'KEEFE",
        "first_name": "AMELIA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-29",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.