Active NPI
Charles D Roth, DDS
- Dentist
- Rock Hall, MD
National Provider Identifier
1568682060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9769
- Practice address
- 5775 Main Street
Rock Hall, MD 21661 - Phone
- (410) 778-1234
- NPI assigned
- Apr 26, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9769 | MD | Primary |
Addresses
Primary practice location
5775 Main Street
Rock Hall, MD 21661
Mailing address
5775 Main Street
P.O. Box 703
Rock Hall, MD 21661
Phone (410) 778-1234
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9769 | Other | MD | MD STATE DENTAL LICENSE # |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9769 | MD | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS. Rodek & Delvecchio, DDS, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Rock Hall Dental
- General Practice Dentistry
- Rock Hall, MD
- NPI 1285428128
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568682060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5775 MAIN STREET",
"address_2": "P.O. BOX 703",
"city": "ROCK HALL",
"state": "MD",
"postal_code": "21661",
"telephone_number": "410-778-1234",
"fax_number": "410-778-0232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5775 MAIN STREET",
"city": "ROCK HALL",
"state": "MD",
"postal_code": "21661",
"telephone_number": "410-778-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "CHARLES",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "9769",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MD STATE DENTAL LICENSE #",
"identifier": "9769",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rock Hall, MD
- Kent County Public Schools Infant & Toddler Program
- Leonard John Litkowski, DDS
- Rock Hall Volunteer Fire Co Inc
- Frances J. Rodney, O.T.
- Tracey Rodney, SLP
- Caroline Diane Louise Speer, PA-C
- Townsend Memorial Medical Clinic
- Walgreen Co (Walgreens #11064)
- Walgreen Co. (Walgreens #11064)
- Whispering Pines Alf LLC
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.