Organization Active NPI

Roth & Norton Family Dentistry

  • Dentist
  • Fairfield, IA
National Provider Identifier
1528608395
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
ROTH & NORTON FAMILY DENTISTRY
Practice address
205 N B St
Fairfield, IA 52556-2944
Phone
(641) 472-3044
NPI assigned
Jan 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Authorized official

Name
Amy Roth
Title
Office Manager
Phone
(641) 472-3044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

205 N B St
Fairfield, IA 52556-2944

Mailing address

205 N B St
Fairfield, IA 52556-2944
Phone (641) 472-3044

Other identifiers 3

IdentifierTypeStateIssuer
1114206513MedicaidIA
0184630MedicaidIA
1881123750MedicaidIA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578528000000",
    "number": "1528608395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N B ST",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525562944",
            "telephone_number": "641-472-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N B ST",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525562944",
            "telephone_number": "641-472-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROTH & NORTON FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-09",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "641-472-3044"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114206513",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0184630",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881123750",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; 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.