Active NPI
Mary Elizabeth Roberts, D.D.S.
- Dentist
- Randolph, NJ
National Provider Identifier
1245779479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22DI01537400
- Practice address
- 8 Laurel Hill Dr
Randolph, NJ 07869-4627 - Phone
- (973) 895-5476
- NPI assigned
- Feb 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22DI01537400 | NJ | Primary |
| Dentist | 122300000X | 0401006046 | VA | |
| Dentist | 122300000X | 2742-15 | WI |
Addresses
Primary practice location
8 Laurel Hill Dr
Randolph, NJ 07869-4627
Mailing address
8 Laurel Hill Dr
Randolph, NJ 07869-4627
Phone (973) 895-5476
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI01537400 | NJ | MD | Dentist |
| 0401006046 | VA | MD | Dentist |
| 2742-15 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487635200000",
"number": "1245779479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 LAUREL HILL DR",
"city": "RANDOLPH",
"state": "NJ",
"postal_code": "078694627",
"telephone_number": "973-895-5476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 LAUREL HILL DR",
"city": "RANDOLPH",
"state": "NJ",
"postal_code": "078694627",
"telephone_number": "973-895-5476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-21",
"last_updated": "2017-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI01537400",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401006046",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "2742-15",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Randolph, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.