Individual provider Active NPI

Lawrence Ira Alan Rothenberg, D.D.S., M.S.

  • Prosthodontics
  • Chevy Chase, MD
National Provider Identifier
1487736898
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
MD5547 Issued in MD
Practice address
5454 Wisconsin Ave
Suite #1350
Chevy Chase, MD 20815-6901
Phone
(301) 652-1545
Fax
(301) 652-4171
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

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
Prosthodontics 1223P0700X MD5547 MD Primary

Addresses

Primary practice location

5454 Wisconsin Ave
Suite #1350
Chevy Chase, MD 20815-6901

Mailing address

5454 Wisconsin Ave
Suite #1350
Chevy Chase, MD 20815-6901
Phone (301) 652-1545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MD5547MDMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487736898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5454 WISCONSIN AVE",
            "address_2": "SUITE #1350",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208156901",
            "telephone_number": "301-652-1545",
            "fax_number": "301-652-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5454 WISCONSIN AVE",
            "address_2": "SUITE #1350",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208156901",
            "telephone_number": "301-652-1545",
            "fax_number": "301-652-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHENBERG",
        "first_name": "LAWRENCE",
        "middle_name": "IRA ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MD",
            "license": "MD5547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.