Roger Lorberbaum, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30547 Issued in NY

Practice address

210 Cornelia Street
Suite 402
Plattsburgh, NY 12901

Phone

(518) 563-7990

Fax

(518) 563-7992

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242604800000",
    "number": "1609953389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 CORNELIA STREET",
            "address_2": "SUITE 402",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "12901",
            "telephone_number": "518-563-7990",
            "fax_number": "518-563-7992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 CORNELIA STREET",
            "address_2": "SUITE 402",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "12901",
            "telephone_number": "518-563-7990",
            "fax_number": "518-563-7992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORBERBAUM",
        "first_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2009-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "030547",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "30547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00374438",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Lindsay
• Caitlyn Lintner, RN
• Jane Zhengyu Liu, M.D.
• Seema A Lodha, M.D.
• Katrina Lopez
• Ashleigh Lord, M.S., LMHC-P
• Lorna J. Clark MD PLLC
• Nichole Louis, RN
• Kristin A. Louise
• Lucy Loyola

• Oral and Maxillofacial Surgery (Dentist) in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; 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.