Provider Demographics
NPI:1902048119
Name:KEEPER, JEREMY HORST (DDS, PHD)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:HORST
Last Name:KEEPER
Suffix:
Gender:
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 SUTTER ST RM 2522
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4208
Mailing Address - Country:US
Mailing Address - Phone:415-906-2069
Mailing Address - Fax:415-390-3130
Practice Address - Street 1:450 SUTTER ST RM 2522
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4208
Practice Address - Country:US
Practice Address - Phone:415-906-2069
Practice Address - Fax:415-390-3130
Is Sole Proprietor?:No
Enumeration Date:2009-04-02
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS624491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice