Miguel A Roque, DMD, MMSC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN1857248 Issued in MA

Practice address

486 Washington St Lowr Level
Wellesley, MA 02482-5971

Phone

(617) 410-8595

NPI assigned

Jun 3, 2016

Last updated

Dec 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Centre Endodontics, LLC

  • Endodontics
  • Wellesley, MA
  • NPI 1801574819
  NPD Authorized official
• North Shore Endodontic Associates, P.C.

  • Endodontics
  • Peabody, MA
  • NPI 1821010877
  NPD (past)

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1275982936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "486 WASHINGTON ST LOWR LEVEL",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024825971",
            "telephone_number": "617-410-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "486 WASHINGTON ST LOWR LEVEL",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024825971",
            "telephone_number": "617-410-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROQUE",
        "first_name": "MIGUEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD, MMSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-03",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "DN1857248",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1857248",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared David Rodrigues, MD
• Alexandra Alexandra Rogers, NP
• Tania Rohany, DMD
• Surbhi Rohatgi, M.D
• Colleen Rooney, NP
• Robert Anthony Rosales
• Stephen M. Rose, PH.D.
• Eric Jon Roseen, D.C.
• Erin Rosen, D.C.
• Martin G. Rosen, D.C.

• Endodontics in Wellesley, MA
• Providers in Wellesley, MA by specialty
• Endodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.