Provider Demographics
NPI:1538287123
Name:O KEEFE, EDWARD SILLS (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:SILLS
Last Name:O KEEFE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 W LITTLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505
Mailing Address - Country:US
Mailing Address - Phone:757-440-7955
Mailing Address - Fax:757-489-5834
Practice Address - Street 1:1232 W LITTLE CREEK RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505
Practice Address - Country:US
Practice Address - Phone:757-440-7955
Practice Address - Fax:757-489-5834
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2106370122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist