NPIMap

Organization Active NPI

Su McNeill, DMD, PLLC

  • Dentist
  • Norfolk, VA
National Provider Identifier
1053853911
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401412524 Issued in VA
Legal business name
SU MCNEILL, DMD, PLLC
Doing business as
O'Keefe Family Dental
Practice address
1232 W Little Creek Rd
Norfolk, VA 23505-1952
Phone
(757) 440-7955
Fax
(757) 489-5834
NPI assigned
Nov 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Beth Teles
Title
Sr. Credentialing Specialist
Phone
(410) 710-6005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 0401412524 VA Primary

Addresses

Primary practice location

1232 W Little Creek Rd
Norfolk, VA 23505-1952

Mailing address

1232 W Little Creek Rd
Norfolk, VA 23505-1952
Phone (757) 440-7955

Other names 1

  • O'Keefe Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1011 W Little Creek Rd
#A
Norfolk, VA 23505
Phone (757) 440-7955

1232 W Little Creek Rd
Norfolk, VA 23505
Phone (757) 440-7955

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478649600000",
    "number": "1053853911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 W LITTLE CREEK RD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235051952",
            "telephone_number": "757-440-7955",
            "fax_number": "757-489-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1232 W LITTLE CREEK RD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235051952",
            "telephone_number": "757-440-7955",
            "fax_number": "757-489-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SU MCNEILL, DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-09",
        "last_updated": "2016-11-09",
        "status": "A",
        "authorized_official_last_name": "TELES",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "SR. CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "410-710-6005"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "O'Keefe Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.