Provider Demographics
NPI:1780641654
Name:KAPLAN, KEITH R (DDS)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:R
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 N BURGHLEY AVE
Mailing Address - Street 2:
Mailing Address - City:VENTNOR CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08406-1104
Mailing Address - Country:US
Mailing Address - Phone:165-090-3025
Mailing Address - Fax:516-783-5848
Practice Address - Street 1:3003 ENGLISH CREEK AVE STE D1
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-4878
Practice Address - Country:US
Practice Address - Phone:609-484-5996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02589701122300000X
NJ22DI025897001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist