Active NPI
Ashok K Rohra Jr., D.D.S., M.S.D.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Creve Coeur, MO
National Provider Identifier
1366856684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 2018000319
- Practice address
- 11255 Olive Blvd Ste 200
Creve Coeur, MO 63141 - Phone
- (314) 624-9373
- NPI assigned
- Jun 14, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 2018000319 | MO | Primary |
Addresses
Primary practice location
11255 Olive Blvd Ste 200
Creve Coeur, MO 63141
Mailing address
11255 Olive Blvd Ste 200
Creve Coeur, MO 63141-7652
Phone (314) 624-9373
Other practice location 1
11255 Olive Blvd Ste 200
Creve Coeur, MO 63141
Phone (314) 624-9373
Other practice location 2
2997 Clarkson Rd Ste 200
Chesterfield, MO 63017-7321
Phone (636) 393-5455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 830063821 | Medicaid | MO |
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 |
|---|---|---|---|
| 2018000319 | MO | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ashok K Rohra Jr DDS , LLC | Orthodontics and Dentofacial Orthopedics | 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 and National Provider Directory roles.
-
dba Olive Orthodontics
- Orthodontics and Dentofacial Orthopedics Dentistry
- Creve Coeur, MO
- NPI 1306343488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1366856684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11255 OLIVE BLVD STE 200",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631417652",
"telephone_number": "314-624-9373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11255 OLIVE BLVD STE 200",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "63141",
"telephone_number": "314-624-9373"
}
],
"practiceLocations": [
{
"address_1": "11255 Olive Blvd Ste 200",
"address_purpose": "LOCATION",
"city": "Creve Coeur",
"state": "MO",
"postal_code": "63141",
"country_code": "US",
"telephone_number": "314-624-9373",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2997 Clarkson Rd Ste 200",
"address_purpose": "LOCATION",
"city": "Chesterfield",
"state": "MO",
"postal_code": "630177321",
"country_code": "US",
"telephone_number": "636-393-5455",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROHRA",
"first_name": "ASHOK",
"middle_name": "K",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.D.S., M.S.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-14",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MO",
"license": "2018000319",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "830063821",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Creve Coeur, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.