Michael Rosenbaum, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DS025205L Issued in PA

Practice address

6404 Roosevelt Blvd
Philadelphia, PA 19149-2943

Phone

(215) 743-3700

Fax

(215) 743-3706

NPI assigned

Aug 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1104810530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492943",
            "telephone_number": "215-743-3700",
            "fax_number": "215-743-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492943",
            "telephone_number": "215-743-3700",
            "fax_number": "215-743-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBAUM",
        "first_name": "MICHAEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS025205L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001148784",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Misha A Rosenbach, MD
• Carl A Rosenbaum, MD
• Dov Rosenbaum
• Jason Nathaniel Rosenbaum, M.D.
• Jennifer Rosenbaum, MD
• Sarah C Rosenbaum, PH.D.
• Anne Lewis Rosenberg, CRNP
• Barbara A Rosenberg, D.P.M.
• Claire Rosenberg, LCSW
• Edwin Rosenberg, B.D.S.H.DIP.DENT.DMD

• Pediatric Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.