Individual provider Active NPI

Ture Dane Roslund, DDS

  • Dentist
  • Placerville, CA
National Provider Identifier
1417965377
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30159 Issued in CA
Practice address
980 Pacific St
Suite a
Placerville, CA 95667
Phone
(530) 622-4188
Fax
(530) 622-1976
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30159 CA Primary

Addresses

Primary practice location

980 Pacific St
Suite a
Placerville, CA 95667

Mailing address

980 Pacific St
Suite a
Placerville, CA 95667
Phone (530) 622-4188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160401000814 CA Order and Referring Only - DentistPractitioner - Dentist 2466759691

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30159CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Minh-Khang Eric Ngo Dental Corporation PastSince Mar 21, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417965377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 PACIFIC ST",
            "address_2": "SUITE A",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "95667",
            "telephone_number": "530-622-4188",
            "fax_number": "530-622-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 PACIFIC ST",
            "address_2": "SUITE A",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "95667",
            "telephone_number": "530-622-4188",
            "fax_number": "530-622-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSLUND",
        "first_name": "TURE",
        "middle_name": "DANE",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "30159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.