Individual provider Active NPI

Marc Rochus Roehrich, DDS

  • Dentist
  • Stillwater, MN
National Provider Identifier
1134196462
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11762 Issued in MN
Practice address
14727 60TH St N
Stillwater, MN 55082-6323
Phone
(651) 439-9060
NPI assigned
Mar 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11762 MN Primary

Addresses

Primary practice location

14727 60TH St N
Stillwater, MN 55082-6323

Mailing address

2185 Woodlane Dr
Woodbury, MN 55125-2916
Phone (651) 731-1560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20151231001655 MN Order and Referring Only - DentistPractitioner - Dentist 0648572099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11762MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Sleep PLLC Dentist Current Accepting new patients
James M. Erlandson, DDS, PA Past Accepting new patients

Locations

2185 Woodlane Dr
Woodbury, MN 55125
Phone (651) 731-1560

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": "1141603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1134196462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 WOODLANE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252916",
            "telephone_number": "651-731-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14727 60TH ST N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826323",
            "telephone_number": "651-439-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEHRICH",
        "first_name": "MARC",
        "middle_name": "ROCHUS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "11762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.