Individual provider Active NPI

Michael Lynn Rosenthal, DDS

  • General Practice Dentistry
  • Novato, CA
National Provider Identifier
1598863607
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
24054 Issued in CA
Practice address
1805 Novato Blvd
Suite #5
Novato, CA 94947-2934
Phone
(415) 892-6901
Fax
(415) 892-8451
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 24054 CA Primary

Addresses

Primary practice location

1805 Novato Blvd
Suite #5
Novato, CA 94947-2934

Mailing address

1805 Novato Blvd
Suite #5
Novato, CA 94947-2934
Phone (415) 892-6901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160324001851 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3577860139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24054CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael L Rosenthal DDS & Rajiv J Anand DDS Inc General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598863607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 NOVATO BLVD",
            "address_2": "SUITE #5",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949472934",
            "telephone_number": "415-892-6901",
            "fax_number": "415-892-8451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 NOVATO BLVD",
            "address_2": "SUITE #5",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949472934",
            "telephone_number": "415-892-6901",
            "fax_number": "415-892-8451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENTHAL",
        "first_name": "MICHAEL",
        "middle_name": "LYNN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "24054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

Verify at the official NPI Registry.