Individual provider Active NPI

Roseanne C Rodgers, DDS

  • General Practice Dentistry
  • Georgetown, SC
National Provider Identifier
1508034273
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9343 Issued in SC
Practice address
1209 N Fraser St
Georgetown, SC 29440-2853
Phone
(843) 546-2273
NPI assigned
Feb 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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 9343 SC Primary

Addresses

Primary practice location

1209 N Fraser St
Georgetown, SC 29440-2853

Mailing address

197 Berkshire Loop
Pawleys Island, SC 29585-6337
Phone (443) 796-5982

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

State licenses

LicenseStateTypeSpecialty
9343SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Charles E Corbett Jr, DMD PastSince Oct 1, 2021 Accepting new patients
Charles E Corbett Jr, DMD PA Dentist PastSince Oct 1, 2021 Accepting new patients
John a. Miller, DMD, LLC General Practice PastSince Nov 10, 2024 Accepting new patients
S. Craig Taylor, D.M.D., P.C. General Practice PastSince Nov 1, 2023 Accepting new patients
Bettis Academy Dentistry, LLC General Practice PastSince Sep 1, 2020 Accepting new patients
Littlestown Smiles, L.L.C. Past Accepting new patients
North Beach Dental General Practice PastSince Nov 1, 2021 Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1508034273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 BERKSHIRE LOOP",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295856337",
            "telephone_number": "443-796-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 N FRASER ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294402853",
            "telephone_number": "843-546-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "ROSEANNE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-15",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.