Joseph Orley Rosenberg, DDS

Individual provider Active NPI General Practice Dentistry · Saint John, KS

NPI 1104886563 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104886563
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
6063 (KS)
Practice address
205 N Santa Fe St
Saint John, KS 67576-2029
Phone
(620) 549-3323
Fax
(620) 549-3914
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6063KSMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6063 KS Yes

Addresses

Primary practice location

205 N Santa Fe St
Saint John, KS 67576-2029

Mailing address

205 N Santa Fe St
St John, KS 67576-2014
Phone (620) 549-3323

Other providers in Saint John, KS

All providers in Saint John, KS · General Practice Dentistry in Kansas

Sources for this page

Verify at the official NPI Registry.