Nicole Rogus, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN29007 Issued in FL

Practice address

23036 Sr-54 E
Unit 403
Lutz, FL 33549

Phone

(813) 909-1317

NPI assigned

Jun 10, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1629810791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 DAWN AVE",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601373706",
            "telephone_number": "224-227-3947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23036 SR-54 E",
            "address_2": "UNIT 403",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "33549",
            "telephone_number": "813-909-1317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGUS",
        "first_name": "NICOLE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN29007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Roebuck
• Bonnie Jean Rogers
• Taylor Rogers
• Tracy Marie Rogers
• Christine Lee Rogienski, O.D.
• Darian Rohn
• Kristen N Rollins
• Rachel Mae Sombilon Romero, PT, DPT
• Lisa Marie Rosa
• Matthew Curtis Rosato

• General Practice Dentistry in Lutz, FL
• Providers in Lutz, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.

Verify at the official NPI Registry.