NPIMap

Organization Active NPI

Bruce W. Roman, D.D.S., P.C.

  • Customized Equipment (DME)
  • Roseburg, OR
National Provider Identifier
1366778441
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
License
D8534 Issued in OR
Legal business name
BRUCE W. ROMAN, D.D.S., P.C.
Practice address
500 SE Douglas Ave
Roseburg, OR 97470-3120
Phone
(541) 672-5721
Fax
(541) 672-7663
NPI assigned
Oct 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Authorized official

Name
Dr. Bruce Walter Roman, D.D.S.NPI 1669519237
Title
President
Phone
(541) 672-5721

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X D8534 OR Primary

Addresses

Primary practice location

500 SE Douglas Ave
Roseburg, OR 97470-3120

Mailing address

500 SE Douglas Ave
Roseburg, OR 97470-3120
Phone (541) 672-5721

National Provider Directory

National Provider Directory

Locations

500 SE Douglas Ave
Roseburg, OR 97470
Phone (541) 672-5721

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1366778441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SE DOUGLAS AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703120",
            "telephone_number": "541-672-5721",
            "fax_number": "541-672-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SE DOUGLAS AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703120",
            "telephone_number": "541-672-5721",
            "fax_number": "541-672-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE W. ROMAN, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-26",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "ROMAN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-672-5721",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "OR",
            "license": "D8534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; 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.