Hala Tannous Roustum, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

047211 Issued in NY

Practice address

646 North French Road
Suite 5
Amherst, NY 14228

Phone

(716) 695-2588

Fax

(716) 264-4031

NPI assigned

Oct 4, 2006

Sex

Female

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 NY

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1356436091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 NORTH FRENCH ROAD",
            "address_2": "SUITE 5",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "14228",
            "telephone_number": "716-695-2588",
            "fax_number": "716-264-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 NORTH FRENCH ROAD",
            "address_2": "SUITE 5",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "14228",
            "telephone_number": "716-695-2588",
            "fax_number": "716-264-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSTUM",
        "first_name": "HALA",
        "middle_name": "TANNOUS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "047211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Elena Rosati, COTA/L
• Amy L Rosen, MSED
• Carolyn Ross, PA
• Nancy Roth, R.N
• Pamela Opal Rouse, LMSW
• David Rowland
• Pamela Rowley
• Zuzanna Maria Rozmus, MD
• Barbara Rubin, ANP
• Stuart Rubin, MD

• General Practice Dentistry in Amherst, NY
• Providers in Amherst, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; 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.