Active NPI
Mariya Rozov, DDS
- Dentist
- Freehold, NJ
National Provider Identifier
1083266969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 061599
- Practice address
- 4257 US 9 Ste a
Freehold, NJ 07728-8310 - Phone
- (732) 639-3495
- NPI assigned
- Jul 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 061599 | NY | Primary |
Addresses
Primary practice location
4257 US 9 Ste a
Freehold, NJ 07728-8310
Mailing address
18 Susanna LN
Staten Island, NY 10312-1340
Phone (347) 261-6731
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
| License | State | Type | Specialty |
|---|---|---|---|
| 061599 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678492800000",
"number": "1083266969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 SUSANNA LN",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103121340",
"telephone_number": "347-261-6731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4257 US 9 STE A",
"city": "FREEHOLD",
"state": "NJ",
"postal_code": "077288310",
"telephone_number": "732-639-3495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROZOV",
"first_name": "MARIYA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-11",
"last_updated": "2023-03-11",
"certification_date": "2023-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "061599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Freehold, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.