Individual provider Active NPI

Robert Gerald Keim, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Los Angeles, CA
National Provider Identifier
1720222383
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
SP 189 Issued in CA
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, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170321000729 NC Order and Referring Only - DentistPractitioner - Dentist 5294010914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP 189CAMDOrthodontics 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

Verify at the official NPI Registry.