Active NPI
Donald Ian Rothenberg, D.M.D.
- General Practice Dentistry
- Marblehead, MA
National Provider Identifier
1295853554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11586
- Practice address
- 11 Angenica Ter
Marblehead, MA 01945-1001 - Phone
- (781) 639-2585
- Fax
- (781) 631-3622
- NPI assigned
- Mar 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 11586 | MA | Primary |
Addresses
Primary practice location
11 Angenica Ter
Marblehead, MA 01945-1001
Mailing address
11 Angenica Ter
Marblehead, MA 01945-1001
Phone (781) 639-2585
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 |
|---|---|---|---|
| 11586 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295853554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 ANGENICA TER",
"city": "MARBLEHEAD",
"state": "MA",
"postal_code": "019451001",
"telephone_number": "781-639-2585",
"fax_number": "781-631-3622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 ANGENICA TER",
"city": "MARBLEHEAD",
"state": "MA",
"postal_code": "019451001",
"telephone_number": "781-639-2585",
"fax_number": "781-631-3622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTHENBERG",
"first_name": "DONALD",
"middle_name": "IAN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "11586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marblehead, MA
- Rides to the Doctor, Inc. (Neighborgood Care)
- Rising Tides Counseling LLC
- David Roberts, PT
- Howard Rosenkrantz, DDS
- Elizabeth Katherine Rostron, MSN, RN
- Amy Gilliam Rowe
- RPH LLC (LTC - Village Pharmacy Marblehead)
- RPH LLC (Village Pharmacy of Marblehead)
- Steven Edward Rubin, M.D.
- Gianna Alexandria Ruiz
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.