Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
JOHNATHON KELLER DDS LLC
Active
Organization
JOHNATHON KELLER DDS LLC
Active
Other names
Decatur Woods Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNATHON M KELLER DDS (DENTIST)
(317) 946-4464
Entity
Organization
Contact information
Practice address
3715 KENTUCKY AVE, INDIANAPOLIS, IN 46221-2757
(317) 946-4464
Mailing address
3715 KENTUCKY AVE, INDIANAPOLIS, IN 46221-2757
(317) 946-4464
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12012526A
IN DENTAL LICENSE
IN
01
—
13885169
CAQH
IN
01
—
1578912341
NPI TYPE 1
IN
05
—
201375420
—
IN
Enumeration date
06/10/2020
Last updated
06/10/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers