Keystone Omfs PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS029213L Issued in PA

Legal business name

KEYSTONE OMFS PC

Practice address

1701 Four Mile Dr
Williamsport, PA 17701-1940

Phone

(570) 323-1900

Fax

(570) 323-6079

NPI assigned

Oct 21, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Marc S Rosenthal, DMD MD

Title

Owner

Phone

(570) 323-1900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Susquehanna Oral & Facial Surgery & Implant Center Doing business as

Locations

Practitioners 2

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

• Charles Matthew Burzynski, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Williamsport, PA
  • NPI 1568579662
  NPD (past)
• Kathleen Claire Lewis

  • Family Medicine Physician
  • Williamsport, PA
  • NPI 1013024157
  NPD (past)

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445385600000",
    "number": "1275905929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 FOUR MILE DR",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011940",
            "telephone_number": "570-323-1900",
            "fax_number": "570-323-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 FOUR MILE DR",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011940",
            "telephone_number": "570-323-1900",
            "fax_number": "570-323-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE OMFS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-21",
        "last_updated": "2015-10-21",
        "status": "A",
        "authorized_official_last_name": "ROSENTHAL",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-323-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS029213L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1699852137",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susquehanna Oral & Facial Surgery & Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeanne M Kerschner, OTRL
• Rachael D. Kershner
• Christine Kessler, PA-C
• Kelly Dae Kettlewell, PH.D.
• Keystone Chiropractic, LTD, PC.
• Ayaz M Khan, M.D.
• Ayesha Asghar Khan, D)
• Rafay Khan, DO
• Saadullah Khan, MD
• Kidney Center Home Therapies LLC

• Oral and Maxillofacial Surgery (Dentist) in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; 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.