Individual provider Active NPI

Astrid M. Risi Rotter, DMD

  • General Practice Dentistry
  • Miami, FL
National Provider Identifier
1104968155
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN13852 Issued in FL
Practice address
12102 SW 102ND St
Miami, FL 33186-2657
Phone
(305) 205-8090
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN13852 FL Primary

Addresses

Primary practice location

12102 SW 102ND St
Miami, FL 33186-2657

Mailing address

12102 SW 102ND St
Miami, FL 33186-2657
Phone (305) 205-8090

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

LicenseStateTypeSpecialty
DN13852FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smile Tree Dental L.L.C. PastSince Jul 13, 2025 Accepting new patients
Ekos Pembroke Pines PastSince Nov 20, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1104968155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12102 SW 102ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862657",
            "telephone_number": "305-205-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12102 SW 102ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862657",
            "telephone_number": "305-205-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISI ROTTER",
        "first_name": "ASTRID",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN13852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.