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DR. KEITH L. RUDOLPH D.D.S.
NPI 1124293196
Dentist in Fairfield, CT

Active since April 29, 2008PECOS Enrolled
140 SHERMAN ST, FAIRFIELD, CT 06824(203) 254-9533 Get Directions Write a Review

NPPES record last updated: April 29, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Keith L. Rudolph D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KEITH L. RUDOLPH D.D.S. (NPI 1124293196) is an individual dentist in Fairfield, Connecticut, licensed in Connecticut (006950) and active in the NPI registry since April 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124293196
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. KEITH L. RUDOLPHCredential: D.D.S.
Location Address140 SHERMAN STFairfield, CT 06824-5849
Mailing Address140 Sherman StFairfield, CT 06824-5849 · (203) 254-9533
Phone(203) 254-9533
Sole ProprietorYes
Enumeration DateApril 29, 2008
✔ NPI 1124293196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CT · 006950
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
140 SHERMAN ST, Fairfield, CT 06824
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Keith L. Rudolph D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06824 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. AIMEE S. ALTSCHUL-LATZMAN M.D.
Allergy & Immunology
140 SHERMAN ST, 3RD FLOOR
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (203) 955-1461
PAINE CENTER FOR NEUROFEEDBACK LLC
Social Worker (Clinical)
140 SHERMAN ST
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (203) 823-5109
DR. ELIZABETH V. BRENNAN M.D.
Physical Medicine & Rehabilitation
140 SHERMAN ST, 2ND FLOOR
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (203) 255-3451
SUSAN SCHEUFELE EDM, LPC
Counselor (Professional)
140 SHERMAN ST
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (203) 858-8182
FAIRFIELD PLASTIC SURGERY, LLC
Surgery (Plastic and Reconstructive Surgery)
140 SHERMAN ST, 3RD FLOOR
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (718) 672-3016
MELISSA MASTROIANNI M.D.
Plastic Surgery
140 SHERMAN ST
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (516) 616-5500
DR. MICHAEL J. BRENNAN M.D.
Physical Medicine & Rehabilitation
140 SHERMAN ST
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (203) 255-3451
MICHAEL J. BRENNAN, M.D. LLC
Physical Medicine & Rehabilitation (Pain Medicine)
140 SHERMAN ST, 2ND FLOOR
FAIRFIELD, CT 06824
Greater Bridgeport Planning Region (203) 255-3451

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keith Rudolph's NPI number?

The NPI number for Keith Rudolph is 1124293196. It was assigned to this individual provider in the NPPES registry on April 29, 2008.

Where is Keith Rudolph located?

Keith Rudolph practices at 140 Sherman St, Fairfield, CT 06824. The listed phone number is (203) 254-9533.

What is Keith Rudolph's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Keith Rudolph enrolled in Medicare?

Yes. Keith Rudolph is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Keith Rudolph was last updated on April 29, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.