Keystone Dental Partners LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS040926 Issued in PA

Legal business name

KEYSTONE DENTAL PARTNERS LLC

Doing business as

Red Lion Dental

Practice address

411 S Main St
Red Lion, PA 17356-2412

Phone

(717) 246-1085

NPI assigned

Nov 24, 2017

Organization subpart

No

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

Authorized official

Name

Dr. David Black, DMDNPI 1164874145

Title

Dentist

Phone

(202) 213-1544

Specialties & licenses 1

Addresses

Other names 1

• Red Lion Dental Doing business as

Practitioners 1

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

• David Detweiler Black, DMD

  • General Practice Dentistry
  • Harrisburg, PA
  • NPI 1164874145
  NPD Authorized official

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

{
    "created_epoch": "1511481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619395200000",
    "number": "1467966713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 S MAIN ST",
            "city": "RED LION",
            "state": "PA",
            "postal_code": "173562412",
            "telephone_number": "717-246-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S MAIN ST",
            "city": "RED LION",
            "state": "PA",
            "postal_code": "173562412",
            "telephone_number": "717-246-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE DENTAL PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-24",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "202-213-1544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS040926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Lion Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kevin John Kanya, DDS
• Victoria Ann Kasaczun, MA, ATR-BC, LPC
• Katie Keller Dailey
• Fred William Kephart, MD
• Brittany Richelle Ketterman, DPT
• Keystone Lab Services LLC
• Steven M Krieger, MD
• Alison M Laguio
• Shannan Lamparski
• Beth A Lawhead, MD

• General Practice Dentistry in Red Lion, PA
• Providers in Red Lion, 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 Apr 26, 2021; 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.