NPIMap

Organization Active NPI

Roeser Dental Associates PC

  • Dentist
  • Clarkston, MI
National Provider Identifier
1235101841
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8615 Issued in MI
Legal business name
ROESER DENTAL ASSOCIATES PC
Practice address
6770 Dixie Hwy
Ste 307
Clarkston, MI 48346
Phone
(248) 620-6800
Fax
(248) 620-6805
NPI assigned
Feb 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jeffery L Roeser, DDSNPI 1477654929
Title
Secretary
Phone
(248) 620-6800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 8615 MI Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 9453 MI
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 16742 MI

Addresses

Primary practice location

6770 Dixie Hwy
Ste 307
Clarkston, MI 48346

Mailing address

6770 Dixie Hwy
Ste 307
Clarkston, MI 48346
Phone (248) 620-6800

National Provider Directory

National Provider Directory

Locations

6770 Dixie Hwy
Ste 307
Clarkston, MI 48346
Phone (248) 620-6800

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235101841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6770 DIXIE HWY",
            "address_2": "STE 307",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "48346",
            "telephone_number": "248-620-6800",
            "fax_number": "248-620-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6770 DIXIE HWY",
            "address_2": "STE 307",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "48346",
            "telephone_number": "248-620-6800",
            "fax_number": "248-620-6805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROESER DENTAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROESER",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "248-620-6800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "8615",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "9453",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "16742",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.