Individual provider Active NPI

Roxolana Maged

  • Dentist
  • Lakewood, CO
National Provider Identifier
1043716988
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
00203271 Issued in CO
Practice address
14255 W Colfax Ave Ste E
Lakewood, CO 80401-3264
Phone
(303) 218-2392
NPI assigned
Mar 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 00203271 CO Primary

Addresses

Primary practice location

14255 W Colfax Ave Ste E
Lakewood, CO 80401-3264

Mailing address

201 E Mississippi Ave Apt 481
Denver, CO 80209-4390

Other identifiers 1

IdentifierTypeStateIssuer
1043716988OtherCODENTIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20231122002544 FL Order and Referring Only - DentistPractitioner - Dentist 0749638104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00203271COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Dental Services of Lakewood PLLC General Practice CurrentSince May 7, 2023 Accepting new patients
Barotz Dental General Practice PastSince Nov 1, 2019 Accepting new patients

Locations

14255 W Colfax Ave
Ste E
Lakewood, CO 80401
Phone (303) 218-2392

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1522454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1043716988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MISSISSIPPI AVE APT 481",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802094390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14255 W COLFAX AVE STE E",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "804013264",
            "telephone_number": "303-218-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGED",
        "first_name": "ROXOLANA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-31",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00203271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "1043716988",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.