Randall Edmund Root, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

2901010725 Issued in MI

Practice address

2677 Elizabeth Lake Rd
Waterford, MI 48328-3290

Phone

(248) 682-8811

Fax

(248) 682-2701

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dr. Delaney & Associates PC

  • Pediatric Dentistry
  • Waterford, MI
  • NPI 1235358219
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407913650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2677 ELIZABETH LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283290",
            "telephone_number": "248-682-8811",
            "fax_number": "248-682-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2677 ELIZABETH LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283290",
            "telephone_number": "248-682-8811",
            "fax_number": "248-682-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "RANDALL",
        "middle_name": "EDMUND",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "2901010725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rogers Chiropractic Center PC
• Dayne James Rogers, D.C.
• Shelly A Rogin
• Laura Rohle, OT
• Jennifer Elizabeth Romanczuk, OTR/L
• Alisa Beth Rosario
• Jamie Rose Rosenthal, PA
• Samantha Leigh Rosso, MSN, APRN, FNP-BC
• Cory Joshua Rubin, M.D.
• Nicholas Ruddy

• Orthodontics and Dentofacial Orthopedics Dentistry in Waterford, MI
• Providers in Waterford, MI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Michigan

• 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.