JOHN T. KEAVENY, DDS (NPI# 1568676310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568676310 |
| Entity Type | Organization |
| Organization Name | JOHN T. KEAVENY, DDS |
| Other Organization Name | ORAL & MAXILLOFACIAL SURGERY |
| Practice Address |
669 12th St W Dickinson ND 58601-3554 |
| Practice Telephone | 7012255163 |
| Practice Fax Number | 7012641032 |
| Mailing Telephone | 7012255163 |
| Mailing Fax Number | 7012641032 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2007-10-04 |
| Authorized Official Name | DR. JOHN TEUNIS KEAVENY (OWNER) |
| Authorized Official Telephone | 7012255163 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
1444 | ND | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 41384 | 05 | |
| ND | BCBS MEDICAL | 26747 | 01 |
| ND | DSC DENTAL | 949318 | 01 |
| Other Name | Type Code |
|---|---|
| Oral & Maxillofacial Surgery | Other Name - Individual/Organization |
| Street Address |
669 12TH ST W |
| City | DICKINSON |
| State | ND |
| Zip Code | 58601-3554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770584500 | John Tennis Keaveny | Dentist | 669 12th St W, Suite 2, Dickinson, ND 58601-3554 | 2005-08-02 |
| 1841898855 | Evan E Entze | Dentist | 669 12th St W, Dickinson, ND 58601-3554 | 2020-10-12 |
| 1548558083 | High Plains Dental | Dentist | 669 12th St W, Dickinson, ND 58601 | 2011-07-19 |
| 1326354499 | Melissa Marie Eberts | Dentist | 669 12th St W, Dickinson, ND 58601-3554 | 2010-08-26 |
| 1003805730 | Lonnie Scott Neuberger | Dentist | 669 12th St W, Dickinson, ND 58601-3554 | 2005-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171235 | Able Inc | Community/Behavioral Health | 1951 1st Street West, Dickinson, ND 58601 | 2020-10-15 |
| 1922626456 | Tess R Johnson, Pllc | Clinic/Center | 579 River Drive, Dickinson, ND 58601 | 2020-07-10 |
| 1295367449 | Winds of Change Counseling Services LLC | Psychologist | 30 7th St. W, Door A, Dickinson, ND 58601 | 2020-02-05 |
| 1588194351 | Nancy Wanner | Case Manager/Care Coordinator | 135 Sims Street, Suite 208, Dickinson, ND 58601 | 2017-06-14 |
| 1518332352 | Chi St. Joseph's Hospital | General Acute Care Hospital | 2500 Fairway St., Dickinson, ND 58601 | 2015-12-04 |
| 1205200359 | Jenna Weisz | Occupational Therapist | 870 Pheasant Run Ave, Dickinson, ND 58601 | 2015-11-29 |
| 1609243450 | Little Missouri Chiropractic, LLC | Chiropractor | 1462 1-94 Business Loop East, Dickinson, ND 58601 | 2015-08-27 |
| 1053799320 | Lisette Michaels | Speech-Language Pathologist | 683 State Ave N, Dickinson, ND 58601 | 2015-05-07 |
| 1336548221 | Neal Steiner | Pharmacist | 352c 1st St E, Dickinson, ND 58601 | 2014-08-18 |
| 1841607793 | Isaac Akinola | Pharmacist | 1681 Third Ave W., Dickinson, ND 58601 | 2014-07-11 |
| Find all providers in zip 58601 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770584500 | John Tennis Keaveny | Dentist | 669 12th St W, Suite 2, Dickinson, ND 58601-3554 | 2005-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343737 | Face and Jaw Surgeons PC | Dentist | 1517 12 Ave Ne, Jamestown, ND 58401 | 2020-10-16 |
| 1649816828 | Dr. Jeremiah J. Glosenger, PC | Dentist | 2615 Elk Dr Ste 3, Minot, ND 58701-1200 | 2019-11-21 |
| 1255759650 | Implant&maxillofacial Surgical Center | Dentist | 2224 1st Ave W Ste 2, Williston, ND 58801-6286 | 2014-04-02 |
| 1477723591 | Oral Surgery Center of Bismarck, PC | Dentist | 3117 N 14th St, Bismarck, ND 58503-0664 | 2008-03-04 |
| 1457420564 | Face and Jaw Surgeons PC | Dentist | 2845 36 Ave South, Grand Forks, ND 58201-6747 | 2006-11-06 |
| 1073697157 | Troy R Petersen | Dentist | 1165c South Columbia Road, Grand Forks, ND 58201-4007 | 2006-10-25 |
| 1790889152 | Rudy J Schneider | Dentist | 3187 Blue Stem Dr Ste 4, West Fargo, ND 58078-8008 | 2006-09-07 |
| 1588697015 | Phillip T. Iero, M.d.,d.d.s., PC | Dentist | 416 N 6th St, Bismarck, ND 58501-4416 | 2006-07-08 |
| 1285670067 | John G Stanley | Dentist | 2331 Tyler Pkwy, Suite 4, Bismarck, ND 58503-0871 | 2006-06-21 |
| 1184667305 | Face and Jaw Surgeons PC | Dentist | 1140 W Capitol Ave, Bismarck, ND 58501-9956 | 2006-06-14 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JOHN T. KEAVENY, DDS.
| 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.