MEDICARE: KEEM SMILE DENTISTRY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	30727	TX

General Provider Information

NPI Number	:	1083115521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEEM SMILE DENTISTRY PLLC

Provider Business Mailing Address
First Line	:	6434 HIGHWAY 6 N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-1310
Country	:	US
Telephone Number	:	832-906-6127
Fax Number	:

Provider Business Practice Location Address
First Line	:	6434 HIGHWAY 6 N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-1310
Country	:	US
Telephone Number	:	832-906-6127
Fax Number	:

Authorized Official
Title or Position	:	GENERAL DENTIST
Name	:	AKEEM AJAYI
Credential	:	DDS
Telephone Number	:	832-906-6127

Provider Enumeration Date	:	02/21/2018
Last Update Date	:	02/21/2018

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