Active NPI
Landi Jennifer Rosenau, DDS
- General Practice Dentistry
- Indian Land, SC
National Provider Identifier
1366965337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9798
- Practice address
- 9456 Charlotte Hwy Ste 202
Indian Land, SC 29707-7953 - Phone
- (803) 766-7973
- NPI assigned
- Jul 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9798 | SC | Primary |
| General Practice Dentistry | 1223G0001X | 10814 | NC |
Addresses
Primary practice location
9456 Charlotte Hwy Ste 202
Indian Land, SC 29707-7953
Mailing address
958 Meadow Vista Dr
Waxhaw, NC 28173-5011
Phone (704) 607-1678
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10814 | Other | NC | DENTAL LISENCE |
| 9798 | Other | SC | DENTAL LISENCE |
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 |
|---|---|---|---|
| 10814 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628553600000",
"number": "1366965337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "958 MEADOW VISTA DR",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281735011",
"telephone_number": "704-607-1678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9456 CHARLOTTE HWY STE 202",
"city": "INDIAN LAND",
"state": "SC",
"postal_code": "297077953",
"telephone_number": "803-766-7973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENAU",
"first_name": "LANDI",
"middle_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-07-21",
"last_updated": "2021-08-10",
"certification_date": "2021-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "9798",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "10814",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LISENCE",
"identifier": "10814",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LISENCE",
"identifier": "9798",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Indian Land, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.