Stacy Roberts, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

2902017012 Issued in MI

Practice address

1535 Lincoln Rd
Allegan, MI 49010-8197

Phone

(269) 673-3619

NPI assigned

Mar 6, 2023

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1508566985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 41ST ST",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490109193",
            "telephone_number": "269-214-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 LINCOLN RD",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490108197",
            "telephone_number": "269-673-3619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "STACY",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": "2902017012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Rewa, MS, OTR/L
• Emily Richardson, MA, TLLP, LLPC
• Rite Aid of Michigan Inc
• Marcus Rivard
• Cheyanne Christina Roberts, PRC, PSS
• Todd Rockhill, LLMSW, QIDP, QMHP
• Katelyn Elizabeth Rodriguez, QIDP, CMHP
• Mario Rodriguez
• Jerilyn Jean Roebling, LMSW
• Charles Ronas, LLBSW

• Dental Hygienist in Allegan, MI
• Providers in Allegan, MI by specialty
• Dental Hygienist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.