Blaine Keister, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI02586000 Issued in NJ

Practice address

146 Route 34
Holmdel, NJ 07733-2407

Phone

(732) 946-4244

Fax

(732) 946-4492

NPI assigned

Jul 1, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1083876031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 ROUTE 34",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332407",
            "telephone_number": "732-946-4244",
            "fax_number": "732-946-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 ROUTE 34",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332407",
            "telephone_number": "732-946-4244",
            "fax_number": "732-946-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEISTER",
        "first_name": "BLAINE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI02586000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonalee P Kapoor, DMD
• Svetlana Kapranova
• Elona Kaso, DMD
• Michael Jason Kaufer, M.D.
• Amanda Kazalonis
• Jaimee Kennedy, AGACNP
• Rafiya S Khakoo, MD
• Rahab Khalil, MD
• Chong S Kim, M.D.
• Sun Mi Lee Kim

• General Practice Dentistry in Holmdel, NJ
• Providers in Holmdel, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.