Individual provider Active NPI

Luis Miguel De la Rosa, DDS

  • Dentist
  • Cleveland, OH
National Provider Identifier
1013607738
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.028382 Issued in OH
Practice address
4071 Lee Rd Suite 260
Cleveland, OH 44128
Phone
(216) 727-0234
NPI assigned
May 8, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.028382 OH Primary

Addresses

Primary practice location

4071 Lee Rd Suite 260
Cleveland, OH 44128

Mailing address

PO Box 241272
Mayfield Heights, OH 44124-8872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30.028382OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1013607738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241272",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441248872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4071 LEE RD SUITE 260",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44128",
            "telephone_number": "216-727-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA ROSA",
        "first_name": "LUIS",
        "middle_name": "MIGUEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-08",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.028382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.