Timothy Jeffrey Rogers, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019028621 Issued in IL

Practice address

6130 W Cermak Rd
Cicero, IL 60804-2025

Phone

(708) 652-2468

Fax

(708) 652-0141

NPI assigned

Jun 2, 2011

Sex

Male

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

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 Aug 21, 2015 through Aug 21, 2027

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.

• Webster Dental Care of Cicero

  • Periodontics
  • Cicero, IL
  • NPI 1659451813
  NPD (past)

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306972800000",
    "number": "1154615557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130 W CERMAK RD",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042025",
            "telephone_number": "708-652-2468",
            "fax_number": "708-652-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 W CERMAK RD",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042025",
            "telephone_number": "708-652-2468",
            "fax_number": "708-652-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "TIMOTHY",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Nasreen Rizvi, BCBA
• Delfina Rodriguez, LSW
• Diane Rodriguez, FNP-C
• Mario Rodriguez
• Olivia Rodriguez
• Jorge Luis Roman
• Romo Dental III PLLC
• Andrea Romo-Serna
• Fernando Romulo Jr.
• Miriam Rosales, MA

• General Practice Dentistry in Cicero, IL
• Providers in Cicero, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; 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.