Active NPI
Kathleen Schroeder Roth, DDS
- Dentist
- Missoula, MT
National Provider Identifier
1255496386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2025
- Practice address
- 725 SW Higgins Ave
Missoula, MT 59803 - Phone
- (406) 728-2745
- Fax
- (406) 728-3953
- NPI assigned
- Dec 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2025 | MT | Primary |
Addresses
Primary practice location
725 SW Higgins Ave
Missoula, MT 59803
Mailing address
725 SW Higgins Ave
Missoula, MT 59803
Phone (406) 728-2745
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20254 | Other | BCBS | |
| 701432 | Other | UNITED CONCORDIA |
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 |
|---|---|---|---|
| 2025 | MT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738022400000",
"number": "1255496386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 SW HIGGINS AVE",
"city": "MISSOULA",
"state": "MT",
"postal_code": "59803",
"telephone_number": "406-728-2745",
"fax_number": "406-728-3953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 SW HIGGINS AVE",
"city": "MISSOULA",
"state": "MT",
"postal_code": "59803",
"telephone_number": "406-728-2745",
"fax_number": "406-728-3953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "KATHLEEN",
"middle_name": "SCHROEDER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-27",
"last_updated": "2025-01-28",
"certification_date": "2025-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MT",
"license": "2025",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "20254",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "701432",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.