Active NPI
Richard Lloyd Roen, DDS
- Prosthodontics
- Washington, DC
National Provider Identifier
1629245477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- DC3593
- Practice address
- 1145 19TH St NW
Suite 502
Washington, DC 20036-3701 - Phone
- (202) 466-6965
- NPI assigned
- May 12, 2008
- 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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | DC3593 | DC | Primary |
Addresses
Primary practice location
1145 19TH St NW
Suite 502
Washington, DC 20036-3701
Mailing address
1145 19TH St NW
Suite 502
Washington, DC 20036-3701
Phone (202) 466-6965
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160725001440 | DC | Order and Referring Only - Dentist | 2365735669 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC3593 | DC | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210550400000",
"number": "1629245477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1145 19TH ST NW",
"address_2": "SUITE 502",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200363701",
"telephone_number": "202-466-6965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1145 19TH ST NW",
"address_2": "SUITE 502",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200363701",
"telephone_number": "202-466-6965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROEN",
"first_name": "RICHARD",
"middle_name": "LLOYD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-12",
"last_updated": "2008-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "DC",
"license": "DC3593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.