Healthcare Provider Details

I. General information

NPI: 1548182025
Provider Name (Legal Business Name): KEITH DENTAL WESTPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 ARCHIBALD ST
KANSAS CITY MO
64111-2230
US

IV. Provider business mailing address

6299 NALL AVE STE 300
MISSION KS
66202-3551
US

V. Phone/Fax

Practice location:
  • Phone: 816-531-0382
  • Fax:
Mailing address:
  • Phone: 913-384-0044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM ROBERT KEITH
Title or Position: PRESIDENT
Credential: DDS
Phone: 913-231-8894