Jose Aristides Roa, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

044819 Issued in NY

Practice address

4071 Denman St
Elmhurst, NY 11373-1608

Phone

(718) 476-1573

Fax

(718) 478-2485

NPI assigned

Aug 16, 2005

Last updated

Nov 5, 2012By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• D.R.P. Dental Industries, Inc,

  • Dental Clinic/Center
  • Elmhurst, NY
  • NPI 1679723308
  NPD (past) Authorized official

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1205828423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4071 DENMAN ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731608",
            "telephone_number": "718-476-1573",
            "fax_number": "718-478-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4071 DENMAN ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731608",
            "telephone_number": "718-476-1573",
            "fax_number": "718-478-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROA",
        "first_name": "JOSE",
        "middle_name": "ARISTIDES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "044819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01460186",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krystal Kayleen Rivera
• Maria Conchita Rivera, LMSW
• Meilani Nia Rivera
• Nancy J Rivera, LCSW
• Natselany Rivera, M.S., CF-SLP, TSSLD
• Roadside Physical Therapy P.C
• Michael Jonathan Robbins, M.D.
• Roberto C. Granato, MDPC
• Roberto Gonzales Javier, Nurse Practitioner in Adult Health, P.L.L.C.
• Ayanna Roberts

• General Practice Dentistry in Elmhurst, NY
• Providers in Elmhurst, 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 Nov 5, 2012; 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.