Individual provider Active NPI

Scott Ian Rothbart, D.D.S

  • Dentist
  • Newark, DE
National Provider Identifier
1104984582
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
G1-0001367 Issued in DE
Practice address
330 Christiana Medical Ctr
Newark, DE 19702-1653
Phone
(302) 369-3200
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS-035668 PA
Dentist 122300000X G1-0001367 DE Primary

Addresses

Primary practice location

330 Christiana Medical Ctr
Newark, DE 19702-1653

Mailing address

32 Cherry Cir
Glen Mills, PA 19342-1294
Phone (610) 687-1257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150708000076 PA Order and Referring Only - DentistPractitioner - Dentist 4082926845

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G1-0001367DEMDDentist
DS-035668PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Atlantic Dental Partners Delaware 1, PA General Practice PastSince Nov 26, 2023 Accepting new patients
Christiana Dental Center General Practice PastSince Nov 26, 2023 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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1104984582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 CHERRY CIR",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421294",
            "telephone_number": "610-687-1257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 CHRISTIANA MEDICAL CTR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197021653",
            "telephone_number": "302-369-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBART",
        "first_name": "SCOTT",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-035668",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DE",
            "license": "G1-0001367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.