Sally M Roushdy

Primary specialty

DentistTaxonomy code 122300000X

License

FAC-40179 Issued in IA

Practice address

801 Newton Road
University of Iowa College of Dentistry
Iowa City, IA 52242

Phone

(319) 335-3188

NPI assigned

Dec 20, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Practice roles

Locations

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.

• State University of Iowa

  • Family Medicine Physician
  • Iowa City, IA
  • NPI 1477554814
  Medicare reassignment NPD
• State University of Iowa

  • Dentist
  • Iowa City, IA
  • NPI 1609956234
  NPD

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1073029591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 WESTGATE ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522464637",
            "telephone_number": "352-281-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 NEWTON ROAD",
            "address_2": "UNIVERSITY OF IOWA COLLEGE OF DENTISTRY",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52242",
            "telephone_number": "319-335-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSHDY",
        "first_name": "SALLY",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-20",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IA",
            "license": "FAC-40179",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "FAC-40179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina M Rottinghaus, DNP
• Mohamed Rouabhi, MD
• Jacinthe Rouleau, MD
• Teal Marie Rounds, PTA
• Robert Scott Roundy, MD
• Carla Sue Rouw, IBCLC, ARNP, CNM
• Miranda Rouw
• Hannah Marie Roux, PA-C
• Danielle Rowan
• Jacob Rowberry

• Dentist in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; 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.