KEITHLINE DIGITAL IMAGING LLC (NPI# 1467680231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1467680231 |
Entity Type | Organization |
Organization Name | KEITHLINE DIGITAL IMAGING LLC |
Other Organization Name | UTICA IMAGING |
Practice Address |
1421 E 13th St Tulsa OK 74120-5207 |
Practice Telephone | 9185853744 |
Practice Fax Number | 9185853774 |
Mailing Telephone | 9185853744 |
Mailing Fax Number | 9185853774 |
Enumeration Date | 2009-06-30 |
Last Update Date | 2009-06-30 |
Authorized Official Name | DR. CHARLES R KEITHLINE III (OWNER) |
Authorized Official Telephone | 9185853744 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223X0008X |
Dentist Specialization: Oral and Maxillofacial Radiology |
784 | OK | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OK | 100635530C | 05 |
Other Name | Type Code |
---|---|
Utica Imaging | Doing Business As Name - Organization |
Street Address |
1421 E 13TH ST |
City | TULSA |
State | OK |
Zip Code | 74120-5207 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932269933 | Charles R. Keithline | Dentist | 1421 E 13th St, Tulsa, OK 74120-5207 | 2006-12-11 |
1366775140 | Ob Dental, LLC | Dentist | 1421 E 13th St, Tulsa, OK 74120-5207 | 2009-09-11 |
1609018548 | Pediatric Dental Group, LLC | Dentist | 1421 E 13th St, Tulsa, OK 74120-5207 | 2009-03-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144704321 | Quintella Delana Miller | Case Manager/Care Coordinator | 1043 E Easton St, Tulsa, OK 74120 | 2018-09-24 |
1689152092 | Charles Granger Jr. | Case Manager/Care Coordinator | 103 N Greenwood, Suite 320, Tulsa, OK 74120 | 2018-07-30 |
1174015598 | Debra Anne Beasley | Counselor | 1619 E. 13th St., Tulsa, OK 74120 | 2018-06-01 |
1649775701 | Cara Marie Cantu | Licensed Practical Nurse | 620 South Peoria, Tulsa, OK 74120 | 2018-03-29 |
1639558745 | Wei Te Li | Student in an Organized Health Care Education/Training Program | 1207 S Quaker Ave Apt 104, Tulsa, OK 74120 | 2015-05-21 |
1225434350 | Marcos Rivero | Community/Behavioral Health | 130 N. Greenwood, Suite 302, Tulsa, OK 74120 | 2014-11-18 |
1861742348 | Tamiika Jones | Social Worker | 1533 E 13th St, Apt B, Tulsa, OK 74120 | 2012-09-12 |
1730408097 | Teresa Lee Henshaw | Physical Therapist | 1125 S. Trenton, Hillcrest Medical Center- Kaiser Rehab. Center, Tulsa, OK 74120 | 2010-05-26 |
1194970384 | Kym Lynnette Lindsay | Speech-Language Pathologist | 1125 S Trenton Ave Fl 3, Tulsa, OK 74120 | 2008-12-01 |
1184872004 | Board of Regents of The University of Oklahoma Ou Physicians Tulsa | Pediatrics | 619 S. Quincy Ave., Ouptch-laura Dester Shelter, Tulsa, OK 74120 | 2008-09-04 |
Find all providers in zip 74120 |
Taxonomy Code | 1223X0008X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Radiology |
The specialty of dentistry and discipline of radiology concerned with the production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730283870 | Farah Masood | Dentist | University of Oklahoma College of Dentistry, 1201 North Stonewall Ave., Oklahoma City, OK 73190 | 2006-09-11 |
Please comment or provide details below to improve the information on KEITHLINE DIGITAL IMAGING LLC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.