Active NPI
Sidney Charles Rosenthal, DMD MSD PA
- Endodontics
- Pensacola, FL
National Provider Identifier
1104005008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN14371
- Practice address
- 4300 Bayou Blvd
Suite 11
Pensacola, FL 32503 - Phone
- (850) 474-9948
- Fax
- (850) 477-4950
- NPI assigned
- Oct 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN14371 | FL | Primary |
Addresses
Primary practice location
4300 Bayou Blvd
Suite 11
Pensacola, FL 32503
Mailing address
4300 Bayou Blvd
Suite 11
Pensacola, FL 32503
Phone (850) 474-9948
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN14371 | FL | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193356800000",
"number": "1104005008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 BAYOU BLVD",
"address_2": "SUITE 11",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "32503",
"telephone_number": "850-474-9948",
"fax_number": "850-477-4950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 BAYOU BLVD",
"address_2": "SUITE 11",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "32503",
"telephone_number": "850-474-9948",
"fax_number": "850-477-4950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENTHAL",
"first_name": "SIDNEY",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "DMD MSD PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-26",
"last_updated": "2007-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN14371",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.