Individual provider Active NPI

Mirta Cristina Roe, D.D.S.

  • Endodontics
  • Murrieta, CA
National Provider Identifier
1366563462
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
45316 Issued in CA
Practice address
39755 Murrieta Hot Springs Rd
Suite D-150
Murrieta, CA 92563-9101
Phone
(951) 461-9886
Fax
(951) 461-0394
NPI assigned
Apr 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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
Endodontics 1223E0200X 45316 CA Primary

Addresses

Primary practice location

39755 Murrieta Hot Springs Rd
Suite D-150
Murrieta, CA 92563-9101

Mailing address

39755 Murrieta Hot Springs Rd
Suite D-150
Murrieta, CA 92563-9101
Phone (951) 461-9886

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

LicenseStateTypeSpecialty
45316CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Roe Professional Dental Corporation Endodontics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366563462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39755 MURRIETA HOT SPRINGS RD",
            "address_2": "SUITE D-150",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925639101",
            "telephone_number": "951-461-9886",
            "fax_number": "951-461-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39755 MURRIETA HOT SPRINGS RD",
            "address_2": "SUITE D-150",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925639101",
            "telephone_number": "951-461-9886",
            "fax_number": "951-461-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROE",
        "first_name": "MIRTA",
        "middle_name": "CRISTINA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "45316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

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.

Verify at the official NPI Registry.