John L. Rottschalk, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019024742 Issued in IL

Practice address

959 Lincoln Hwy
Fairview Heights, IL 62208-2234

Phone

(618) 624-3838

Fax

(618) 624-4478

NPI assigned

Feb 2, 2007

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: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 20, 2015 through Aug 20, 2027

Medicare enrollment (NPD)

Not 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.

• John Rottschalk, DMD, PC

  • General Practice Dentistry
  • Fairview Heights, IL
  • NPI 1336354539
  NPD (past) Authorized official
• Rottschalk Dental LLC

  • Dentist
  • Fairview Heights, IL
  • NPI 1487574455
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1164560710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 LINCOLN HWY",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082234",
            "telephone_number": "618-624-3838",
            "fax_number": "618-624-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 LINCOLN HWY",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082234",
            "telephone_number": "618-624-3838",
            "fax_number": "618-624-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTTSCHALK",
        "first_name": "JOHN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019024742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juan Romero, BS-P
• Faith Rebecca Rose, LCSW
• Mark Allen Rosenkoetter Jr.
• Madosin Orion Rothenhoefer
• Rottschalk Dental LLC
• Timothy E Routh
• Tatiana Routt
• James Patrick Rybak, M.D.
• Sheena Nicole Sadlowski, CMA
• Taylor Sallis

• General Practice Dentistry in Fairview Heights, IL
• Providers in Fairview Heights, 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 Oct 9, 2014; 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.