Organization Active NPI

Keystone Oral Surgery Associates PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Lewisburg, PA
National Provider Identifier
1356204036
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
KEYSTONE ORAL SURGERY ASSOCIATES PC
Practice address
1 Hospital Dr
Lewisburg, PA 17837-9350
Phone
(570) 884-8321
Fax
(570) 256-1772
NPI assigned
Dec 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Authorized official

Name
Dr. Pranathi Reddy, DDS
Title
Owner
Phone
(267) 809-2364

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

1 Hospital Dr
Lewisburg, PA 17837-9350

Mailing address

30 Baldwin Blvd Ste 95
Shamokin Dam, PA 17876-9520
Phone (570) 234-3555

National Provider Directory

National Provider Directory
Tax ID family
Keystone Oral Surgery Associates PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1765152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765152000000",
    "number": "1356204036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BALDWIN BLVD STE 95",
            "city": "SHAMOKIN DAM",
            "state": "PA",
            "postal_code": "178769520",
            "telephone_number": "570-234-3555",
            "fax_number": "570-256-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379350",
            "telephone_number": "570-884-8321",
            "fax_number": "570-256-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE ORAL SURGERY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-08",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "PRANATHI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-809-2364",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.