NPIMap

Organization Active NPI

Keithline Digital Imaging LLC

Doing business as Utica Imaging

  • Oral and Maxillofacial Radiology Dentistry
  • Tulsa, OK
National Provider Identifier
1467680231
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X
License
784 Issued in OK
Legal business name
KEITHLINE DIGITAL IMAGING LLC
Doing business as
Utica Imaging
Practice address
1421 E 13TH St
Tulsa, OK 74120-5207
Phone
(918) 585-3744
Fax
(918) 585-3774
NPI assigned
Jun 30, 2009
Last updated
Jun 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Authorized official

Name
Dr. Charles R Keithline III, DDSNPI 1932269933
Title
Owner
Phone
(918) 585-3744

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Radiology DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0008X 784 OK Primary

Addresses

Primary practice location

1421 E 13TH St
Tulsa, OK 74120-5207

Mailing address

1421 E 13TH St
Tulsa, OK 74120-5207
Phone (918) 585-3744

Other names 1

  • Utica Imaging Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1467680231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 E 13TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741205207",
            "telephone_number": "918-585-3744",
            "fax_number": "918-585-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 E 13TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741205207",
            "telephone_number": "918-585-3744",
            "fax_number": "918-585-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITHLINE DIGITAL IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "KEITHLINE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-585-3744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0008X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "OK",
            "license": "784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Utica Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.