Individual provider Active NPI

Stephen Roth, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Baltimore, MD
National Provider Identifier
1083187538
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
LL935 Issued in MD
Practice address
650 W Baltimore St FL 7
Baltimore, MD 21201-1510
Phone
(410) 706-8345
NPI assigned
Jan 8, 2019
Last updated
Feb 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 061196 NY
Oral and Maxillofacial Pathology Dentistry 1223P0106X LL935 MD Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

650 W Baltimore St FL 7
Baltimore, MD 21201-1510

Mailing address

650 W Baltimore St FL 7
Baltimore, MD 21201-1510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210723000052 NY Practitioner - PathologyPractitioner - Maxillofacial SurgeryPractitioner - Dentist 2769727460 Reassigns benefits to 4 organizations
I20250729002723 MD Practitioner - Oral and Maxillofacial Pathology 2769727460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
061196NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Apr 16, 2021 Accepting new patients
U M FDSP Associates PA CurrentSince May 17, 2025 Accepting new patients
Black Hall Dental, P.C. CurrentSince Jan 2, 2024 Accepting new patients
Black Hall Dental, P.C. CurrentSince Jan 2, 2024 Accepting new patients
White Hall Dental, PC Oral and Maxillofacial Pathology CurrentSince Jul 1, 2023 Accepting new patients
Lenox Otolaryngology Head & Neck Surgery PC CurrentSince Jan 2, 2024 Accepting new patients
Oral Medicine Consultants Oral and Maxillofacial Pathology CurrentSince May 17, 2025 Accepting new patients

Locations

650 W Baltimore St
Baltimore, MD 21201
Phone (410) 706-3964

650 W Baltimore St
Fl 7
Baltimore, MD 21201
Phone (410) 706-8345

650 W Baltimore St
Rm 5201
Baltimore, MD 21201
Phone (410) 706-7063

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

10 Medical Plz
Ste 210
Glen Cove, NY 11542
Phone (516) 674-7646

300 Community Dr
Manhasset, NY 11030

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

186 E 76th St
Fl 2
New York, NY 10021
Phone (212) 327-3000

366 5th Ave
Rm 709
New York, NY 10001
Phone (212) 629-3223

27005 76th Ave
North New Hyde Pk, NY 11040

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1083187538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 W BALTIMORE ST FL 7",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 W BALTIMORE ST FL 7",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011510",
            "telephone_number": "410-706-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-08",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NY",
            "license": "061196",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MD",
            "license": "LL935",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.