Individual provider Active NPI

Rinat Roth, DDS

  • General Practice Dentistry
  • Glen Rock, NJ
National Provider Identifier
1295956696
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DI21265 Issued in NJ
Practice address
39 Wellesley Rd
Glen Rock, NJ 07452-1222
Phone
(201) 670-0097
Fax
(201) 445-0225
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DI21265 NJ Primary

Addresses

Primary practice location

39 Wellesley Rd
Glen Rock, NJ 07452-1222

Mailing address

39 Wellesley Rd
Glen Rock, NJ 07452-1222
Phone (201) 670-0097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20150611000203 NJ Order and Referring Only - DentistPractitioner - Dentist 1052632452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI21265NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Visiting Dental PC General Practice Past Accepting new patients
Bright Smile a Visiting Dental Service of NJ LLC General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295956696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 WELLESLEY RD",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521222",
            "telephone_number": "201-670-0097",
            "fax_number": "201-445-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 WELLESLEY RD",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521222",
            "telephone_number": "201-670-0097",
            "fax_number": "201-445-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "RINAT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI21265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Rock, NJ

Sources for this page

Verify at the official NPI Registry.