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Active NPI 1790416345 Individual Practitioner Male Practitioner

Dr. Payton Keller , DDS

Dentist - General Practice • Fort Worth, TX

Professional Overview & Biography Verified Profile Summary

Dr. Payton Keller, DDS is a registered healthcare professional specializing in Dentist - General Practice in Fort Worth, TX. Practice services are available at 4930 CAMP BOWIE BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4930 Camp Bowie Blvd

Fort Worth, TX 761074153

Telephone 4022169318
Associated Practice Facility / Clinic
🏢 Cowtown Dental Facility NPI 1760117808

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Fort Worth, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 7.0 Yrs
State Avg: 12.3 Yrs
Regional Practice Density
289 Specialists

Practicing in Fort Worth, TX (10570 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: 2022-06-23
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TX 38483

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

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

2 Associated Practitioners
Dr. William Cook , DDS

Dentist - General Practice

NPI 1467583294

Doctor of Dental Surgery

Dr. Philip Cordell , DDS

Dentist - General Practice

NPI 1497886931

Doctor of Dental Surgery

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active June 23, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location June 23, 2022

Registered at 4930 CAMP BOWIE BLVD, FORT WORTH, TX 761074153 (Tel: 4022169318)

📍
Updated Business Mailing Address June 23, 2022

Registered at 2640 WATERS EDGE LN, FORT WORTH, TX 761160521

👤
Provider Name / Credentials Updated June 23, 2022

Recorded as PAYTON KELLER, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 23, 2022

Dentist (License #38483 in TX)

🟢
Initial NPI Registration & Enumeration June 23, 2022

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: 1790416345
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 23, 2022
Last Update: June 23, 2022
Sole Proprietor: Yes

Mailing Address

2640 Waters Edge Ln

Fort Worth, TX 761160521

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.