Active NPI
Gerald Michael Roan, DMD
- General Practice Dentistry
- Falmouth, MA
National Provider Identifier
1306913439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 15353
- Practice address
- 205 Worcester CT
Suite C2
Falmouth, MA 02540 - Phone
- (508) 548-1699
- Fax
- (508) 548-1641
- NPI assigned
- Nov 30, 2006
- 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 | 15353 | MA | Primary |
Addresses
Primary practice location
205 Worcester CT
Suite C2
Falmouth, MA 02540
Mailing address
205 Worcester CT
Suite C2
Falmouth, MA 02540
Phone (508) 548-1699
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 |
|---|---|---|---|
| 15353 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306913439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 WORCESTER CT",
"address_2": "SUITE C2",
"city": "FALMOUTH",
"state": "MA",
"postal_code": "02540",
"telephone_number": "508-548-1699",
"fax_number": "508-548-1641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 WORCESTER CT",
"address_2": "SUITE C2",
"city": "FALMOUTH",
"state": "MA",
"postal_code": "02540",
"telephone_number": "508-548-1699",
"fax_number": "508-548-1641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROAN",
"first_name": "GERALD",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "15353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Falmouth, MA
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.