Heidi M. Roth

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

4219-016 Issued in WI

Practice address

S2845 White Eagle Rd
Baraboo, WI 53913-9064

Phone

(608) 355-1240

NPI assigned

Feb 7, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Heidi M. Santos Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376683698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W8595 BILKIE RD",
            "city": "POYNETTE",
            "state": "WI",
            "postal_code": "539559774",
            "telephone_number": "608-635-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S2845 WHITE EAGLE RD",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539139064",
            "telephone_number": "608-355-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "HEIDI",
        "middle_name": "M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WI",
            "license": "4219-016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "SANTOS",
            "middle_name": "M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Layna M Robinson, PA-C
• Debra K Rodriguez, NP
• Rhonda D Roll
• Angela Romportl
• Donna T. Rose, PH.D.
• Jennifer L Roth, FNP-C
• Mary Ann Roth, LPC
• Jane Rufe
• April Ruhland, MS, CCC-SLP
• Valerie M Rung, MA, LPC-IT

• Dental Hygienist in Baraboo, WI
• Providers in Baraboo, WI by specialty
• Dental Hygienist in Wisconsin

• 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.