Jonathan Roden, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9515 Issued in KY

Practice address

11900 Standiford Plaza Dr
Louisville, KY 40229-5901

Phone

(502) 977-8565

NPI assigned

Jun 29, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Locations

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.

• Dental Health Professionals of Kentucky, P.S.C.

  • General Practice Dentistry
  • Louisville, KY
  • NPI 1902589799
  NPD

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1477817864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 STANDIFORD PLAZA DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402295901",
            "telephone_number": "859-608-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 STANDIFORD PLAZA DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402295901",
            "telephone_number": "502-977-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEN",
        "first_name": "JONATHAN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-29",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9515",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick Rockhold III, M.D.
• Vanessa Rockwell
• Rocky Mountain Holdings, LLC
• Nina Rodahaffer, APRN
• Eric Meyer Roddy
• Courtney E Rodewig, CSW
• Alexis Danielle Rodgers, PHD
• Cassie Rodgers, DC
• Christopher Rodgers, DC
• Farrah Hill Rodgers, COTA/L

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.