Susan Roshan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

23018 Issued in TX

Practice address

5437 E Grand Ave
Dallas, TX 75223-1914

Phone

(214) 821-4726

Fax

(214) 821-8403

NPI assigned

Dec 15, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

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.

• 1St Class Dentistry and Orthodontics PA

  • General Practice Dentistry
  • Dallas, TX
  • NPI 1215209929
  NPD (past)
• Grand Dental PA

  • Dental Clinic/Center
  • Dallas, TX
  • NPI 1184933400
  NPD (past)

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

{
    "created_epoch": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1467697714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5437 E GRAND AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752231914",
            "telephone_number": "214-821-4726",
            "fax_number": "214-821-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5437 E GRAND AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752231914",
            "telephone_number": "214-821-4726",
            "fax_number": "214-821-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSHAN",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-15",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5349",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344998501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Brian Rosero-Mora, M.D.
• Rebecca Rosero, CAA
• Charlotte Elizabeth Rosetta, LVN
• Megan Leigh Rosewell
• Michelle Rosewell
• Medya Roshanrou, DDS
• Diane Dunkin Rosics
• Rosies Hope PLLC
• Gregory L Roslund, MD
• Zachary Paul Rosol, M.D.

• General Practice Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.