Mark Rex Rosenthall, DDS, MSD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

12010065 Issued in IN

Practice address

3901 N Wheeling Ave
Muncie, IN 47304-1769

Phone

(765) 289-2377

Fax

(765) 289-3909

NPI assigned

Jun 5, 2019

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1417515255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 N WHEELING AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473041769",
            "telephone_number": "765-289-2377",
            "fax_number": "765-289-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 N WHEELING AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473041769",
            "telephone_number": "765-289-2377",
            "fax_number": "765-289-3909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6535 S State Road 67 Ste 100",
            "address_purpose": "LOCATION",
            "city": "Pendleton",
            "state": "IN",
            "postal_code": "460649490",
            "country_code": "US",
            "telephone_number": "765-374-5365",
            "fax_number": "765-289-3909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENTHALL",
        "first_name": "MARK",
        "middle_name": "REX",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IN",
            "license": "12010065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily B Rose, M.D.
• Starr Rose
• Mary Jo Roseberry, PH.D.
• Rosenthall Orthodontics
• Rosenthall Orthodontics PC
• Kaileigh Ross
• Kara Jane Ross
• Kayla Ross
• Tyler Ross
• Steve L Rousseau, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Muncie, IN
• Providers in Muncie, IN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.

Verify at the official NPI Registry.