Nicole Roberge, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

Practice address

1028 Edgewater Corporate Pkwy Ste 101
Indian Land, SC 29707-0187

Phone

(803) 835-2500

NPI assigned

Oct 22, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1508630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508630400000",
    "number": "1174034722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 MARLOWE AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282085028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 EDGEWATER CORPORATE PKWY STE 101",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297070187",
            "telephone_number": "803-835-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERGE",
        "first_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-22",
        "last_updated": "2017-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revive Dental Aesthetics LLC
• Revlis Medical, LLC
• Dani Jaclyn Rinaldo, PHARMD
• RM Invests
• RM Stores
• Nathan Lee Roberson, LPC
• Danielle Roberts, PA
• Helmut Roberts
• Kershina Robinson
• Susan Anne Robinson, C-FNP

• Dental Hygienist in Indian Land, SC
• Providers in Indian Land, SC by specialty
• Dental Hygienist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.