Active NPI
Jason J. Roan, D.D.S.
- General Practice Dentistry
- Glendive, MT
National Provider Identifier
1285851014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1925
- Practice address
- 218 W Bell St Ste 102
Glendive, MT 59330-1644 - Phone
- (406) 377-2303
- Fax
- (406) 377-3950
- NPI assigned
- Apr 20, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1925 | MT | Primary |
Addresses
Primary practice location
218 W Bell St Ste 102
Glendive, MT 59330-1644
Mailing address
218 W Bell St Ste 102
PO Box 1171
Glendive, MT 59330-1644
Phone (406) 377-2303
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 |
|---|---|---|---|
| 1925 | MT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312848000000",
"number": "1285851014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "218 W BELL ST STE 102",
"address_2": "PO BOX 1171",
"city": "GLENDIVE",
"state": "MT",
"postal_code": "593301644",
"telephone_number": "406-377-2303",
"fax_number": "406-377-3950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "218 W BELL ST STE 102",
"city": "GLENDIVE",
"state": "MT",
"postal_code": "593301644",
"telephone_number": "406-377-2303",
"fax_number": "406-377-3950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROAN",
"first_name": "JASON",
"middle_name": "J.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-20",
"last_updated": "2011-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MT",
"license": "1925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendive, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.