Keith Libou

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

024178 Issued in PA

Practice address

790 Penllyn Blue Bell Pike
Blue Bell, PA 19422-1656

Phone

(215) 646-3900

NPI assigned

Feb 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437298494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 PENLLYN BLUE BELL PIKE",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 PENLLYN BLUE BELL PIKE",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221656",
            "telephone_number": "215-646-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBOU",
        "first_name": "KEITH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "024178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra M Leibold, M.D.
• Deborah Ann Lem, DC
• Leonis Marie Perone (Blue Bell Counseling Associates)
• Mark S Lepore, MD
• Erin Lewis, CRNP
• Simmonette Ponferrada Libre-Sabio, PT
• Nora J Lin, MD
• Hugh Lipshutz, MD
• Sadiq Locus
• Longevity100 Homecare Agency LLC

• General Practice Dentistry in Blue Bell, PA
• Providers in Blue Bell, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.