Individual provider Active NPI

Richard Paul Keim Jr., DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Marietta, GA
National Provider Identifier
1750331419
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN013508 Issued in GA
Practice address
1000 Johnson Ferry Rd
BLDG H
Marietta, GA 30068-2114
Phone
(770) 977-0364
Fax
(678) 819-6536
NPI assigned
May 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN013508 GA Primary

Addresses

Primary practice location

1000 Johnson Ferry Rd
BLDG H
Marietta, GA 30068-2114

Mailing address

1000 Johnson Ferry Rd
BLDG H
Marietta, GA 30068-2114
Phone (770) 977-0364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070806000066 GA Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 9537250592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
University of Kansas School of Med (KC/Wich/Sal), 1992
Medicare assignment
May accept Medicare assignment
Group practices
Atlanta Oral and Facial Surgery LLCGroup PAC ID 8628062387, 24 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd
BLDG H
Marietta, GA 30068-5518
Phone (770) 977-0364

1350 Ctr Dr
Suite 100
Dunwoody, GA 30338-4134
Phone (404) 255-2559

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
512KSMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Oral & Facial Surgery LLC Oral and Maxillofacial Surgery CurrentSince Jul 1, 2007 Accepting new patients

Locations

3400 Old Milton Pkwy
Ste C525
Alpharetta, GA 30005

1350 Center Dr
Ste 100
Dunwoody, GA 30338
Phone (404) 255-2559

1000 Johnson Ferry Rd
Bldg H
Marietta, GA 30068
Phone (770) 973-4344

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750331419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD",
            "address_2": "BLDG H",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682114",
            "telephone_number": "770-977-0364",
            "fax_number": "678-819-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD",
            "address_2": "BLDG H",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682114",
            "telephone_number": "770-977-0364",
            "fax_number": "678-819-6536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIM",
        "first_name": "RICHARD",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN013508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.