Individual provider Active NPI

Roham Rafat, DDS

  • Periodontics
  • Owings Mills, MD
National Provider Identifier
1114246071
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
14025 Issued in MD
Practice address
5 Park Center CT Ste 302
Owings Mills, MD 21117-4203
Phone
(410) 356-7799
NPI assigned
May 18, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 14025 MD Primary

Addresses

Primary practice location

5 Park Center CT Ste 302
Owings Mills, MD 21117-4203

Mailing address

5 Park Center CT Ste 302
Owings Mills, MD 21117-4203
Phone (410) 356-7799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective May 12, 2015 through May 12, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14025MDMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Edward S. Lazer, D.D.S., P.C. Past Accepting new patients

Organizations & group practices 1

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": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1114246071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PARK CENTER CT STE 302",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174203",
            "telephone_number": "410-356-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PARK CENTER CT STE 302",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174203",
            "telephone_number": "410-356-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFAT",
        "first_name": "ROHAM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-18",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MD",
            "license": "14025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

Verify at the official NPI Registry.