Provider Demographics
NPI:1104267541
Name:VANBEEK, KEITH ALLEN (DDS)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ALLEN
Last Name:VANBEEK
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 1:1210 NW 18TH ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-7846
Mailing Address - Country:US
Mailing Address - Phone:515-964-5700
Mailing Address - Fax:515-965-7922
Practice Address - Street 1:1210 NW 18TH ST
Practice Address - Street 2:SUITE 140
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-7846
Practice Address - Country:US
Practice Address - Phone:515-964-5700
Practice Address - Fax:515-965-7922
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-09021122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist