Brian David Roberts, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8192 Issued in WA

Practice address

2409 Borst Ave
Centralia, WA 98531-1411

Phone

(360) 736-8380

Fax

(360) 736-2192

NPI assigned

Sep 19, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ash & Roberts DDS PLLC

  • General Practice Dentistry
  • Centralia, WA
  • NPI 1043332745
  NPD (past)

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1285820720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1660",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985310752",
            "telephone_number": "360-736-8380",
            "fax_number": "360-736-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 BORST AVE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311411",
            "telephone_number": "360-736-8380",
            "fax_number": "360-736-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BRIAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "8192",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "5151",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "606932",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS",
            "identifier": "5038930",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Riverside Fire Authority
• Riverside Nursing - Centralia LLC
• Riverside Nursing - Centralia LLC
• Alejandra Maria Robbins
• Ona C Robbins, RN
• Jodee M Roberts, LAT, ATC
• Donnia Maria Robinson
• Stanley Wade Robinson, MD
• Jerald Rodman, LICSW
• Francisco Rodriguez Fontan, MD

• General Practice Dentistry in Centralia, WA
• Providers in Centralia, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; 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.