MEDICARE: AMANDA ERIN KEENE DDS

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	1223G0001X	General Practice Dentistry	30.027282	OH

General Provider Information

NPI Number	:	1295435055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA ERIN KEENE DDS

Provider Business Mailing Address
First Line	:	3525 W DUBLIN GRANVILLE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43235-7900
Country	:	US
Telephone Number	:	614-764-1178
Fax Number	:

Provider Business Practice Location Address
First Line	:	3525 W DUBLIN GRANVILLE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43235-7900
Country	:	US
Telephone Number	:	614-764-1178
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2023
Last Update Date	:	04/06/2026

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