Victoria A Rouse, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

109230 Issued in CA

Practice address

2103 McHenry Ave Ste C
Modesto, CA 95350-3264

Phone

(209) 435-9550

NPI assigned

Aug 28, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Michael Lopez Dental Corporation

  • Dentist
  • Modesto, CA
  • NPI 1821461104
  NPD (past)

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1124803150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4064 ST REMY CT",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953489541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 MCHENRY AVE STE C",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953503264",
            "telephone_number": "209-435-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSE",
        "first_name": "VICTORIA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Rossini Jr., M.D.
• Alyssa Marie Rostran
• Patricia Roten
• Ravyn Roth
• Carlie Rounds
• Elisha Feroze Roy
• Nisha Ann Roy
• Ronald Joseph Roy
• James Royel
• Marek Zenon Rozycki, M.D.

• All providers in Modesto, CA
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.