Michael Steven Rothberg, D.D.S

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

038685-1 Issued in NY

Practice address

99 Hillside Ave
Suite C
Williston Park, NY 11596-2333

Phone

(516) 741-6410

Fax

(516) 741-6419

NPI assigned

Jul 19, 2005

Last updated

Feb 24, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 27, 2015 through Mar 27, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1154320448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 HILLSIDE AVE",
            "address_2": "SUITE C",
            "city": "WILLISTON PARK",
            "state": "NY",
            "postal_code": "115962333",
            "telephone_number": "516-741-6410",
            "fax_number": "516-741-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 HILLSIDE AVE",
            "address_2": "SUITE C",
            "city": "WILLISTON PARK",
            "state": "NY",
            "postal_code": "115962333",
            "telephone_number": "516-741-6410",
            "fax_number": "516-741-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBERG",
        "first_name": "MICHAEL",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "038685-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane M Roche
• Rebecca Boyle Rodricks, MA, CCC-SLP
• Sinead Rodriguez
• Dora Roxana Roman
• Martin Dennis Ronan, PA-C
• Glen W Rowell, PT MA OCS
• Susan Rubenstein, PHD
• Jennifer Elyse Rubin, PHARMD
• Bruce A Rudin, D.P.M.
• Jessica Rupp, MS

• Oral and Maxillofacial Surgery (Dentist) in Williston Park, NY
• Providers in Williston Park, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.