DR. KEITH A. BOENNING (NPI# 1376678482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376678482 |
| Entity Type | Individual |
| Full Name | DR. KEITH A. BOENNING |
| Credential | D.D.S., LLC |
| Practice Address |
1104 Kenilworth Dr Suite 104 Towson MD 21204-2101 |
| Practice Telephone | 4108281717 |
| Practice Fax Number | 4108210912 |
| Mailing Telephone | 4108281717 |
| Mailing Fax Number | 4108210912 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2008-07-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
8257 | MD | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | FEDERAL TAX ID | 26-2579369 | 01 |
| Street Address |
1104 KENILWORTH DR SUITE 104 |
| City | TOWSON |
| State | MD |
| Zip Code | 21204-2101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841240470 | Stanley Joseph Miller | Dermatology | 1104 Kenilworth Dr, Ste 201, Towson, MD 21204-2101 | 2006-05-12 |
| 1366727034 | Eric J Lane Psy D Pa | Clinic/Center | 1104 Kenilworth Dr, Suite 302, Towson, MD 21204-2101 | 2011-10-13 |
| 1548558158 | Melody D Ward | Dentist | 1104 Kenilworth Dr, Suite #102, Towson, MD 21204-2101 | 2011-07-17 |
| 1255625844 | Yula Ponticas, Ph.d., P.a. | Clinic/Center | 1104 Kenilworth Dr, Suite 210, Towson, MD 21204-2101 | 2011-06-01 |
| 1730485715 | Devon Byrne Conklin | Dentist | 1104 Kenilworth Dr, Suite 102, Towson, MD 21204-2101 | 2011-02-08 |
| 1912202094 | Anthony J. Kameen M D P A | Ophthalmology | 1104 Kenilworth Dr, Suite 200, Towson, MD 21204-2101 | 2011-01-20 |
| 1326162025 | Christine Garwood | Social Worker | 1104 Kenilworth Dr, Suite 210, Towson, MD 21204-2101 | 2007-03-19 |
| 1821130246 | Stanley J Miller Md Pa | Specialist | 1104 Kenilworth Dr, Ste 201, Towson, MD 21204-2101 | 2007-02-13 |
| 1801952346 | Kenilworth Surgery Center LLC | Surgery | 1104 Kenilworth Dr, Ste 201, Towson, MD 21204 | 2006-12-29 |
| 1194807727 | Anthony Kameen Jr. | Ophthalmology | 1104 Kenilworth Dr, Suite 400, Towson, MD 21204-2101 | 2006-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194347575 | Sheppard Pratt Non Contracted Services, LLC | Psychiatry & Neurology | 6525 N. Charles Street, Gibson Building, Towson, MD 21204 | 2020-05-08 |
| 1578104428 | Debra James | Counselor | 6901 N. Charles Street, Towson, MD 21204 | 2019-10-02 |
| 1235696808 | Sarita Hinton | Social Worker | 300 Allegheny Ave Ste 101, Baltimore, MD 21204 | 2019-03-01 |
| 1952883159 | Peace,llc | Social Worker | 304 W. Chesapeake Ave, Towson, MD 21204 | 2018-09-04 |
| 1841772654 | Hannah Kimberly Jefferson | Acupuncturist | 7407 York Road, Towson, MD 21204 | 2018-08-29 |
| 1699255216 | Samantha Ann Rogers | Nurse Practitioner | 222 Bosley Avenue, Suite C3, Towson, MD 21204 | 2018-08-14 |
| 1750867560 | Angela Michelle Hester | Nurse Practitioner | 6525 N Charles St #085, Towson, MD 21204 | 2018-07-15 |
| 1043729098 | Communication Apptitude Inc. | Speech-Language Pathologist | 7400 York Road, Suite 231, Towson, MD 21204 | 2017-09-21 |
| 1679090203 | Brian Dougherty | Acupuncturist | 800 Kenilworth Dr, Ste# 828, Towson, MD 21204 | 2017-08-24 |
| 1659891976 | Erin Mcgovern | Specialist/Technologist | Towson Sports Medicine 8322 Bellona Ave, Suite Number 100, Baltimore, MD 21204 | 2017-06-27 |
| Find all providers in zip 21204 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932216108 | Albert Louis Ousborne Jr. | Dentist | 21 West Rd, 104, Towson, MD 21204-2325 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417473273 | Andrey Doroshenko | Dentist | 1722 Underwood Road, Sykesville, MD 21784 | 2017-08-14 |
| 1275902298 | Yeremi A Canizales Dds P A | Dentist | 572 Ritchie Hwy Ste F, Severna Park, MD 21146-2966 | 2015-09-21 |
| 1770911273 | Fotini Chrisopoulos | Dentist | 11 N Eutaw St Apt 405, Baltimore, MD 21201-1794 | 2013-10-18 |
| 1548514730 | Churchton Dental Care | Dentist | 5570 Shady Side Rd, Unit A, Churchton, MD 20733-9639 | 2012-11-09 |
| 1124396551 | Guadalupe Garcia Fay | Dentist | 650 W Baltimore St # 4220, Baltimore, MD 21201-1510 | 2011-12-13 |
| 1598033136 | Mark Edward Brennan | Dentist | 882 Backbone Ct, Westminster, MD 21157-7745 | 2011-12-11 |
| 1366738536 | William E. Chmar | Dentist | 5952 Hubbard Dr, Rockville, MD 20852-4824 | 2011-06-25 |
| 1073812913 | Family Cosmetic & Implant Dentistry | Dentist | 3222 Powder Mill Rd, Adelphi, MD 20783-1037 | 2011-03-17 |
| 1831499433 | Stuart L. Graves Dental Associates, P.C. | Dentist | 11200 Rockville Pike Ste 115, Rockville, MD 20852-7114 | 2010-10-28 |
| 1578707204 | Andrea Denise Jackson | Dentist | 6912 Wade Ave, Clinton, MD 20735-2743 | 2009-04-24 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. KEITH A. BOENNING.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.