Individual provider Active NPI

Beth Rosenberg, D.D.S.

  • General Practice Dentistry
  • Belleville, MI
National Provider Identifier
1265570436
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901017506 Issued in MI
Practice address
9840 Haggerty Rd
Belleville, MI 48111-3443
Phone
(734) 697-4400
Fax
(734) 697-0519
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901017506 MI Primary

Addresses

Primary practice location

9840 Haggerty Rd
Belleville, MI 48111-3443

Mailing address

9840 Haggerty Rd
Belleville, MI 48111-3443
Phone (734) 697-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150202001464 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0648595264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901017506MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265570436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9840 HAGGERTY RD",
            "city": "BELLEVILLE",
            "state": "MI",
            "postal_code": "481113443",
            "telephone_number": "734-697-4400",
            "fax_number": "734-697-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9840 HAGGERTY RD",
            "city": "BELLEVILLE",
            "state": "MI",
            "postal_code": "481113443",
            "telephone_number": "734-697-4400",
            "fax_number": "734-697-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "BETH",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, MI

Sources for this page

Verify at the official NPI Registry.