Keith M Rogers, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

AZ4750 Issued in AZ

Practice address

55 S 63Rd Street
Suite 1
Mesa, AZ 85206-1605

Phone

(480) 830-5100

Fax

(480) 854-0751

NPI assigned

Feb 9, 2007

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

Other names 1

• Dr. Keith Rogers Professional name

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1063553386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 S 63RD STREET",
            "address_2": "SUITE 1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061605",
            "telephone_number": "480-830-5100",
            "fax_number": "480-854-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 S 63RD STREET",
            "address_2": "SUITE 1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061605",
            "telephone_number": "480-830-5100",
            "fax_number": "480-854-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "KEITH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "AZ4750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEITH",
            "last_name": "ROGERS",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kaleigh Marie Roeder, OTR
• Tamara Lee Roehling, PT
• Richard Roger, CRNA
• Ben Rogers
• Denton R Rogers, DDS, MSD, PC
• Lianne Ka'Uilani Rogers, PT, DPT
• Mackenzie Ann Rogers
• Nathan Stephen Rogers, FNP-C
• Steven Rogers, OTR
• Zabrina Rogers, FNP-C

• General Practice Dentistry in Mesa, AZ
• Providers in Mesa, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.