Active NPI
Robert Gerald Keim, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Los Angeles, CA
National Provider Identifier
1720222383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- SP 189
- Practice address
- Usc School of Dentistry Department of
925 West 34TH Street, Suite 312
Los Angeles, CA 90089-0001 - Phone
- (213) 740-0410
- NPI assigned
- Apr 27, 2009
- Last updated
- Dec 13, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | SP 189 | CA | Primary |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 1412 | NM | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 0183 | NC |
Addresses
Primary practice location
Usc School of Dentistry Department of
925 West 34TH Street, Suite 312
Los Angeles, CA 90089-0001
Mailing address
1851 Macgregor Downs Rd
Mail Stop 701
Greenville, NC 27834-5925
Phone (252) 737-7023
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170321000729 | NC | Order and Referring Only - Dentist | 5294010914 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP 189 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481587200000",
"number": "1720222383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1851 MACGREGOR DOWNS RD",
"address_2": "MAIL STOP 701",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278345925",
"telephone_number": "252-737-7023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "USC SCHOOL OF DENTISTRY DEPARTMENT OF",
"address_2": "925 WEST 34TH STREET, SUITE 312",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900890001",
"telephone_number": "213-740-0410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEIM",
"first_name": "ROBERT",
"middle_name": "GERALD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-27",
"last_updated": "2016-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "SP 189",
"primary": true
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NM",
"license": "1412",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NC",
"license": "0183",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.