KEISHA MONIQUE BUTLER D.D.S NPI 1164834628

NPI Information

  • NPI: 1164834628
  • Provider Name: KEISHA MONIQUE BUTLER, D.D.S
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 85 W BURNSIDE AVE
    BRONX, NY
    ZIP 10453
  • Phone: (718) 716-4400

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NPI Details

Keisha Monique Butler, D.D.S is a general practice dentist in Bronx, NY with 12 years of experience. The provider is 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. Keisha Monique Butler, D.D.S NPI is 1164834628. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: CREIGHTON UNIVERSITY SCHOOL OF DENTISTRY
Graduation Year:2014

The provider's business location address is:

85 W BURNSIDE AVE
BRONX, NY
ZIP 10453-015
Phone: (718) 716-4400

The NPI 1164834628 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 6/2/2014 and was last updated on 8/5/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice058135NEW YORKYes
21223G0001XDentistGeneral Practice2017012302MISSOURINo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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