BRYCE MARK KEEN (NPI# 1619574688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619574688 |
| Entity Type | Individual |
| Full Name | BRYCE MARK KEEN |
| Credential | DDS |
| Practice Address |
9606 Baseline Rd Alta Loma CA 91701-5035 |
| Mailing Address |
5029 Lomas Ct Rancho Cucamonga CA 91737-1542 |
| Practice Telephone | 9099896661 |
| Practice Fax Number | 9099896663 |
| Mailing Telephone | 9097147105 |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2020-10-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
105639 | CA | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 16922 Main St Ste F, Hesperia, CA 923456011 | 7602444844 |
| Street Address |
9606 BASELINE RD |
| City | ALTA LOMA |
| State | CA |
| Zip Code | 91701-5035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215130448 | C Mark Keen | Dentist | 9606 Baseline Rd, Alta Loma, CA 91701 | 2007-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558884882 | Alinda Joan Kniss | Speech-Language Pathologist | 8990 19 Th Street #304, Alta Loma, CA 91701 | 2017-07-19 |
| 1164739595 | Andrea G Moore-emmett | Counselor | 9330 Baseline Rd Ste 102, Rancho Cucamonga, CA 91701 | 2010-09-07 |
| 1053548644 | Suniel S. Khemlani | Family Medicine | 11398 Kenyon Way Ste J, Rancho Cucamonga, CA 91701 | 2009-06-22 |
| 1184845711 | Andrew Liu | Specialist/Technologist | 11801 Lark Dr., Rancho Cucamonga, CA 91701 | 2007-05-01 |
| 1083741359 | Rockcreek, Inc. | Intermediate Care Facility, Mentally Retarded | 10227 Monte Vista Street, Rancho Cucamonga, CA 91701 | 2007-02-27 |
| 1194867788 | George Ji Jun Tao | Dentist | 6626 Carnelian St, Alta Loma, CA 91701 | 2007-02-12 |
| 1265590624 | Terry F Brock | Dentist | 7283 Carnelian St, Alta Loma, CA 91701 | 2006-12-05 |
| 1851461354 | Dr Tom Dental Office | Dentist | 6795 Carnelian St, Alta Loma, CA 91701 | 2006-11-09 |
| 1124127956 | Johnny S Liu | Dentist | 7168 Archibald Ave, Suite 200, Alta Loma, CA 91701 | 2006-09-21 |
| 1578903175 | Andrew Paul Clack | Marriage & Family Therapist | 9330 Baseline Rd Ste 102, Rancho Cucamonga, CA 91701 | 2013-06-27 |
| Find all providers in zip 91701 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073032330 | Kristin Joy Smits | Dentist | 10458 Vivienda St, Alta Loma, CA 91737-1753 | 2017-09-18 |
| 1215130448 | C Mark Keen | Dentist | 9606 Baseline Rd, Alta Loma, CA 91701 | 2007-06-06 |
| 1417176835 | Bharat Mansukhlal Rajpara | Dentist | 8750 19th St, Alta Loma, CA 91701-4608 | 2007-04-24 |
| 1144327784 | Wendy Sugiono | Dentist | 9482 Baseline Rd, Alta Loma, CA 91701-5822 | 2006-09-17 |
| 1679973036 | Wendy Sugiono, Dds, Magd, Inc. | Dentist | 9482 Baseline Rd, Alta Loma, CA 91701-5822 | 2014-09-03 |
| 1881972644 | Michael Kim | Dentist | 7283 Carnelian St, Alta Loma, CA 91701-5526 | 2011-07-28 |
| 1457555476 | L. Todd Cochran | Dentist | 7283 Carnelian St, Alta Loma, CA 91701-5526 | 2007-06-13 |
| 1477683621 | Tuan D Nguyen | Dentist | 10431 Lemon Ave, Suite K, Alta Loma, CA 91737-3700 | 2007-03-06 |
| 1548390701 | Trinh Pham | Dentist | 10431 Lemon Ave, Suite K, Alta Loma, CA 91737-3700 | 2007-03-06 |
| 1467550723 | Jeffrey D Lloyd | Dentist | 9310 Baseline Rd, Alta Loma, CA 91701-5821 | 2006-09-20 |
| Find all providers in ALTA LOMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.