Tyson J Roethlisberger, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901015834 Issued in MI

Practice address

721 N Macomb St
Suite 3
Monroe, MI 48162-2982

Phone

(734) 241-6710

Fax

(734) 241-6710

NPI assigned

Jan 5, 2006

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

Enrolled in MI

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.

• Junita Bahroos, DDS

  • Dental Clinic/Center
  • Brownstown TWP, MI
  • NPI 1861001422
  NPD

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1487632949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 N MACOMB ST",
            "address_2": "SUITE 3",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481622982",
            "telephone_number": "734-241-6710",
            "fax_number": "734-241-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 N MACOMB ST",
            "address_2": "SUITE 3",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481622982",
            "telephone_number": "734-241-6710",
            "fax_number": "734-241-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROETHLISBERGER",
        "first_name": "TYSON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901015834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Roberto, PA-C, ATC
• Michelle Lee Roberts
• Trent Anthony Roberts, DO
• Nicholle Robinson
• Jeannette Rodenbeck, RN
• Teresa Roggow
• Haley Rohde, MS
• Ashley Rohr
• Leslie Anne Rohr, LMSW
• Marialba Romero Medina, M.D.

• General Practice Dentistry in Monroe, MI
• Providers in Monroe, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.