MEDICARE: DR. JEREMY HORST KEEPER DDS, PHD

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	DDS62449	CA

General Provider Information

NPI Number	:	1902048119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEREMY HORST KEEPER DDS, PHD

Provider Business Mailing Address
First Line	:	450 SUTTER ST RM 2522
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94108-4208
Country	:	US
Telephone Number	:	415-906-2069
Fax Number	:	415-390-3130

Provider Business Practice Location Address
First Line	:	450 SUTTER ST RM 2522
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94108-4208
Country	:	US
Telephone Number	:	415-906-2069
Fax Number	:	415-390-3130

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

Provider Enumeration Date	:	04/02/2009
Last Update Date	:	03/14/2025

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