NPIMap

Organization Active NPI

Edgar D. Roque, D.D.S.,Inc

  • Dentist
  • Fresno, CA
National Provider Identifier
1699077487
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
55681 Issued in CA
Legal business name
EDGAR D. ROQUE, D.D.S.,INC
Practice address
420 W. Shields Ave
Fresno, CA 93705-4107
Phone
(559) 412-4702
Fax
(559) 473-1475
NPI assigned
Nov 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Authorized official

Name
Dr. Edgar RoqueNPI 1467645812
Title
Dentist/President
Phone
(559) 412-4702

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 55681 CA Primary

Addresses

Primary practice location

420 W. Shields Ave
Fresno, CA 93705-4107

Mailing address

420 W. Shields Ave
Fresno, CA 93705-4107
Phone (559) 412-4702

National Provider Directory

National Provider Directory
Tax ID family
Edgar D Roque DDS Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297728000000",
    "number": "1699077487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W. SHIELDS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937054107",
            "telephone_number": "559-412-4702",
            "fax_number": "559-473-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W. SHIELDS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937054107",
            "telephone_number": "559-412-4702",
            "fax_number": "559-473-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGAR D. ROQUE, D.D.S.,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2011-02-15",
        "status": "A",
        "authorized_official_last_name": "ROQUE",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "559-412-4702",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "55681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.