Individual provider Active NPI

Laura Aileen Rosendaul, HYGIENIST

  • Dental Hygienist
  • White City, OR
National Provider Identifier
1558036616
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
H4699 Issued in OR
Practice address
8385 Division Rd
White City, OR 97503-1176
Phone
(541) 826-5853
Fax
(541) 826-5843
NPI assigned
Aug 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X H4699 OR Primary

Addresses

Primary practice location

8385 Division Rd
White City, OR 97503-1176

Mailing address

1000 E Main St
Medford, OR 97504-7667
Phone (541) 826-5853

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
H4699ORMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1558036616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047667",
            "telephone_number": "541-826-5853",
            "fax_number": "541-826-5843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8385 DIVISION RD",
            "city": "WHITE CITY",
            "state": "OR",
            "postal_code": "975031176",
            "telephone_number": "541-826-5853",
            "fax_number": "541-826-5843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENDAUL",
        "first_name": "LAURA",
        "middle_name": "AILEEN",
        "credential": "HYGIENIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H4699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.