Glenn Kevin Rochlen, DENTIST

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

040418 Issued in NY

Practice address

11206 Springfield Blvd
Queens Village, NY 11429-2650

Phone

(718) 479-4100

NPI assigned

May 29, 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

Other identifiers 1

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455840000000",
    "number": "1194926287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 TONI PL",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118033041",
            "telephone_number": "718-479-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11206 SPRINGFIELD BLVD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292650",
            "telephone_number": "718-479-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHLEN",
        "first_name": "GLENN",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DENTIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2016-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "040418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01285890",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ritecare Medical Supplies
• Phoebe Robinson, M.S., CCC-SLP, TSSLD
• Michelle Rocha
• Rochdale Obstetrics & Gynecology P C
• Vladine R Roche
• Pauline Rock I
• Daniela Rodriguez, CCC-SLP
• Iveth Y Rodriguez
• Natalie Rodriguez
• Cliff Rogers, D.D.S.

• General Practice Dentistry in Queens Village, NY
• Providers in Queens Village, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; 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.