Keeton, Gokli, Lubbe, Bridges-Poquis & Raddin,

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

0401004876 Issued in VA

Legal business name

KEETON, GOKLI, LUBBE, BRIDGES-POQUIS & RADDIN,

Practice address

13841 Hull Street Rd
Suite 4
Midlothian, VA 23112-2056

Phone

(804) 739-0963

Fax

(804) 739-0965

NPI assigned

Jul 18, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Carol Roper

Title

Practice Administrator

Phone

(804) 739-0963

Specialties & licenses 5

Addresses

Other names 1

• Pediatric Dentistry and Orthodontics of Virginia Doing business as

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297382400000",
    "number": "1366460107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13841 HULL STREET RD",
            "address_2": "SUITE 4",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122056",
            "telephone_number": "804-739-0963",
            "fax_number": "804-739-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13841 HULL STREET RD",
            "address_2": "SUITE 4",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122056",
            "telephone_number": "804-739-0963",
            "fax_number": "804-739-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEETON, GOKLI, LUBBE, BRIDGES-POQUIS & RADDIN,",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2011-02-11",
        "status": "A",
        "authorized_official_last_name": "ROPER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "804-739-0963",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401410240",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401007234",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401004876",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401410225",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401004475",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dentistry and Orthodontics of Virginia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Savneet Kaur
• Charles W Keblusek, M.D.,F.A.C.O.G.,P.C.
• Ariyana Keels, RN
• Mariana Keener, DO
• James Austin Keesee, PT, DPT
• James Pierce Kegley III, LAT, ATC
• Scott B Kegley, LPC
• Derek Kegyeda
• Hamilton Keith, PT
• Kevin Erick Kelleher, D.M.D

• Pediatric Dentistry in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Pediatric Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; 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.