Individual provider Active NPI

Robert Michael Roiter, D.D.S.

  • General Practice Dentistry
  • Glenview, IL
National Provider Identifier
1487720686
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-022299 Issued in IL
Practice address
3633 W Lake Ave
Suite 411
Glenview, IL 60026-5805
Phone
(847) 729-4994
Fax
(847) 729-4996
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019-022299 IL Primary

Addresses

Primary practice location

3633 W Lake Ave
Suite 411
Glenview, IL 60026-5805

Mailing address

3633 W Lake Ave
Suite 411
Glenview, IL 60026-5805
Phone (847) 729-4994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20160427001580 IL Order and Referring Only - DentistPractitioner - Dentist 4385943281

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-022299ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1487720686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE",
            "address_2": "SUITE 411",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265805",
            "telephone_number": "847-729-4994",
            "fax_number": "847-729-4996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE",
            "address_2": "SUITE 411",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265805",
            "telephone_number": "847-729-4994",
            "fax_number": "847-729-4996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROITER",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-022299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.