Individual provider Active NPI

William Carter Roth, DDS

  • Endodontics
  • Colorado Springs, CO
National Provider Identifier
1376743369
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
7521 Issued in CO
Practice address
2116 Hollow Brook Dr
Siute # 200
Colorado Springs, CO 80918-1442
Phone
(719) 597-0038
Fax
(719) 597-6239
NPI assigned
Jul 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 7521 CO Primary

Addresses

Primary practice location

2116 Hollow Brook Dr
Siute # 200
Colorado Springs, CO 80918-1442

Mailing address

2116 Hollow Brook Dr
Siute # 200
Colorado Springs, CO 80918-1443
Phone (719) 597-0038

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

LicenseStateTypeSpecialty
7521COMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1376743369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 HOLLOW BROOK DR",
            "address_2": "SIUTE # 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181443",
            "telephone_number": "719-597-0038",
            "fax_number": "719-597-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 HOLLOW BROOK DR",
            "address_2": "SIUTE # 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181442",
            "telephone_number": "719-597-0038",
            "fax_number": "719-597-6239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "WILLIAM",
        "middle_name": "CARTER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CO",
            "license": "7521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.