Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1578912341 Individual Practitioner Male Practitioner

Dr. Johnathan Michael Keller , DDS

Dentist • Indianapolis, IN

Professional Overview & Biography Verified Profile Summary

Dr. Johnathan Keller, DDS is a registered healthcare professional specializing in Dentist in Indianapolis, IN. Practice services are available at 1130 W MICHIGAN ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1130 W Michigan St
Fh204

Indianapolis, IN 462025209

Telephone 3172740076
Fax 3172740256
Associated Practice Facility / Clinic
🏢 Sarahakard, D.d.s., P. C. Facility NPI 1356729883

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Indianapolis, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.0 Yrs
State Avg: 7.1 Yrs
Regional Practice Density
361 Specialists

Practicing in Indianapolis, IN (1682 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-06-10
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License IN 12012526A

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
201375420 (IN)
Commercial Insurance / Payer ID Npi Type 1
1578912341 (IN)
Commercial Insurance / Payer ID Caqh
13885169 (IN)
Commercial Insurance / Payer ID In Dental License
12012526A (IN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1013545540

Doctor of Medicine (M.D.)

NPI 1023641982

Doctor of Osteopathic Medicine (D.O.)

David Lee , CAA

Anesthesiologist Assistant

NPI 1023882016
Dr. Isaac Hunter , MD

Student in an Organized Health Care Education/Training Program

NPI 1033812623

Doctor of Medicine (M.D.)

NPI 1043742521

Doctor of Osteopathic Medicine (D.O.)

NPI 1063099109

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Business Mailing Address June 10, 2020

Registered at 3715 KENTUCKY AVE, INDIANAPOLIS, IN 462212757 (Tel: 3179464464)

NPI Profile Active June 12, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location June 12, 2016

Registered at 1130 W MICHIGAN ST, FH204, INDIANAPOLIS, IN 462025209 (Tel: 3172740076)

📍
Updated Business Mailing Address June 12, 2016

Registered at 1130 W MICHIGAN ST, FH204, INDIANAPOLIS, IN 462025209 (Tel: 3172740076)

👤
Provider Name / Credentials Updated June 12, 2016

Recorded as JOHNATHAN KELLER, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 12, 2016

Dentist (License #12012526A in IN)

🟢
Initial NPI Registration & Enumeration June 12, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1578912341
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 12, 2016
Last Update: June 10, 2020
Sole Proprietor: No

Mailing Address

3715 Kentucky Ave

Indianapolis, IN 462212757

Phone: 3179464464

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.