Roseville Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

D10509 Issued in MN

Legal business name

ROSEVILLE DENTISTRY

Practice address

1912 Lexington Ave N
Suite 100
Roseville, MN 55113-6113

Phone

(651) 489-1900

NPI assigned

Sep 11, 2015

Last updated

Sep 11, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tamara Simons, DDSNPI 1437139870

Title

Owner

Phone

(651) 269-7061

Specialties & licenses 1

Addresses

Other names 1

• Tamara Simons & Associates Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tamara Lynn Simons, DDS

  • Dentist
  • Roseville, MN
  • NPI 1437139870
  NPD (past) Authorized official

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441929600000",
    "number": "1366810061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 LEXINGTON AVE N",
            "address_2": "SUITE 100",
            "city": "ROSEVILEE",
            "state": "MN",
            "postal_code": "551136105",
            "telephone_number": "651-489-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 LEXINGTON AVE N",
            "address_2": "SUITE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551136113",
            "telephone_number": "651-489-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEVILLE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-11",
        "status": "A",
        "authorized_official_last_name": "SIMONS",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-269-7061",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D10509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tamara Simons & Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rose of Sharon
• Lisa Chong Rose, LPCC
• Rosenberg Center Assessment and Treatment for Children & Families PA
• Rosenberg Center: Assessment and Treatment for Children and Families
• Roseville Assisted Living LLC
• Roseville Dentistry
• Roseville Family Dental Care, P.a.
• Roseville Independent School District 623
• Roseville Independent School District 623
• Roseville Opco, LLC

• Dentist in Roseville, MN
• Providers in Roseville, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.