Joel Lawrence Rosenlicht, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

005324 Issued in CT

Practice address

483 Middle Tpke W
Manchester, CT 06040-3863

Phone

(860) 649-2272

Fax

(860) 533-1010

NPI assigned

Aug 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295744118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 MIDDLE TUNRPIKE WEST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060401926",
            "telephone_number": "860-649-2272",
            "fax_number": "860-533-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 MIDDLE TPKE W",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403863",
            "telephone_number": "860-649-2272",
            "fax_number": "860-533-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENLICHT",
        "first_name": "JOEL",
        "middle_name": "LAWRENCE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "005324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Rose
• Ellen A Roseen, LO
• David Jeremy Rosenberg, M.D.
• Henry Rosenberg, DMD
• Edward M Rosenblatt, MD
• Janice C Rosinski
• Daniel L. Ross, R.PH.
• Deanna Ross
• Michelle Rossignol
• Lori Ann Marie Rossitto, LCSW

• Oral and Maxillofacial Surgery (Dentist) in Manchester, CT
• Providers in Manchester, CT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.