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General NPI Number Information
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NPI Number | 1083414676
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Entity Type | Organization
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Legal Business Name | JEREMY KEEPER DDS PHD DENTAL CORPORATION
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Dates
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Enumeration Date | 03/14/2025
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 450 SUTTER ST RM 2522
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City | SAN FRANCISCO
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State | CA
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Zip | 94108-4208
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Country | US
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Telephone | 415-906-2069
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Fax |
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Provider Business Mailing Address
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Address Line | 450 SUTTER ST RM 2522
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City | SAN FRANCISCO
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State | CA
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Zip | 94108-4208
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Country | US
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Telephone | 415-906-2069
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Fax |
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | DR. JEREMY KEEPER
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Credential | DDS, PHD
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Telephone | 415-370-0061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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