Samantha Roach, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D13028 Issued in MN

Practice address

15015 Cimarron Ave
Rosemount, MN 55068-2771

Phone

(612) 558-6033

NPI assigned

May 12, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Samantha Roach Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1083932230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 BRYANT AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195359",
            "telephone_number": "612-558-6033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15015 CIMARRON AVE",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550682771",
            "telephone_number": "612-558-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-12",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "R448",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "D13028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "ROACH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicholas James Rapp, D.C.
• Rachelle Reinisch, LMFT
• Jesma Candace Revering
• Eric Jonathan Rice, D.C.
• Dylan Riggs, DC
• Jenna Marie Rock, LGSW
• Edgar Leonel Rodriguez Mendez
• Rosemount Family Dentistry PA
• Rosemount Minnesota Orthodontics
• Rosemount Senior Living Operations, LLC

• Endodontics in Rosemount, MN
• Providers in Rosemount, MN by specialty
• Endodontics in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.