Active NPI
Susan Roche, D.D.S.
- Oral and Maxillofacial Pathology Dentistry
- Loma Linda, CA
National Provider Identifier
1679780670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Pathology Dentistry
- License
- 41530
- Practice address
- 11092 Anderson Street
Loma Linda, CA 92354 - Phone
- (909) 558-4613
- NPI assigned
- May 17, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Oral and Maxillofacial Pathology Dentistry | 1223P0106X | 41530 | CA | Primary |
Addresses
Primary practice location
11092 Anderson Street
Loma Linda, CA 92354
Mailing address
11092 Anderson Street
Loma Linda, CA 92354
Phone (909) 558-4613
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41530 | Other | CA | STATE LICENSE NUMBER |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dignity Health | 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.
-
- General Acute Care Hospital
- San Bernardino, CA
- NPI 1689769911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679780670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11092 ANDERSON STREET",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "92354",
"telephone_number": "909-558-4613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11092 ANDERSON STREET",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "92354",
"telephone_number": "909-558-4613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROCHE",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0106X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Pathology",
"state": "CA",
"license": "41530",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "41530",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
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.