Forest Richard Robertson II, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7653 Issued in IN

Practice address

515 S Illinois St
Monticello, IN 47960

Phone

(574) 583-5100

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003904806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S MAIN ST",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479602532",
            "telephone_number": "574-583-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S ILLINOIS ST",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "47960",
            "telephone_number": "574-583-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "FOREST",
        "middle_name": "RICHARD",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "7653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Relieve Therapy Services, Inc. (Annare's Physical Therapy)
• Ilona Gocza Richards, FNP-BC
• Mark Andrew Riese, DDS
• Stephanie Roach
• Elizabeth Cooley Roberds, RN
• Mary Kathleen Rodkey
• Christy L Rund, NP
• Richard Charles Russell, LMHC
• Mary Beth Sabados
• Safe T Home Care Inc (Safe T Home Care Incl)

• General Practice Dentistry in Monticello, IN
• Providers in Monticello, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.