Individual provider Active NPI

Roslyn Joseph, DMD

  • Dentist
  • San Diego, CA
National Provider Identifier
1689492381
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
110874 Issued in CA
Practice address
575 Camino de la Reina Ste 100
San Diego, CA 92108-3386
Phone
(619) 573-4889
NPI assigned
Oct 1, 2024
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 110874 CA Primary

Addresses

Primary practice location

575 Camino de la Reina Ste 100
San Diego, CA 92108-3386

Mailing address

575 Camino de la Reina Ste 100
San Diego, CA 92108-3386

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
I20250630003807 CA Order and Referring Only - DentistPractitioner - Dentist 6002329398

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110874CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Chilmeran Dental Corporation Dentist CurrentSince Oct 6, 2024 Accepting new patients

Locations

575 Camino de la Reina
Ste 100
San Diego, CA 92108
Phone (619) 573-4889

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1689492381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 CAMINO DE LA REINA STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 CAMINO DE LA REINA STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083386",
            "telephone_number": "619-573-4889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "ROSLYN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "110874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.