Healthcare Provider Details

I. General information

NPI: 1568528289
Provider Name (Legal Business Name): MICHAEL KEVIN KEATING DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 W GARDEN ST STE 205
AUBURN NY
13021
US

IV. Provider business mailing address

37 W GARDEN ST STE 205
AUBURN NY
13021-2657
US

V. Phone/Fax

Practice location:
  • Phone: 315-282-0063
  • Fax: 315-282-0124
Mailing address:
  • Phone: 315-282-0063
  • Fax: 315-282-0124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number043531
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: