Paul a Roggow DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

9644 Issued in MN

Legal business name

PAUL A ROGGOW DDS PC

Practice address

604 Second Street
Jackson, MN 56143-1646

Phone

(507) 847-3910

Fax

(507) 847-2868

NPI assigned

Feb 12, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul Anthony Roggow, DDSNPI 1285978221

Title

Owner Dentist

Phone

(507) 847-3910

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul Anthony Roggow, D.D.S.

  • Dentist
  • Jackson, MN
  • NPI 1285978221
  Authorized official Same address or phone

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699817437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 SECOND STREET",
            "city": "JACKSON",
            "state": "MN",
            "postal_code": "561431646",
            "telephone_number": "507-847-3910",
            "fax_number": "507-847-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 SECOND STREET",
            "city": "JACKSON",
            "state": "MN",
            "postal_code": "561431646",
            "telephone_number": "507-847-3910",
            "fax_number": "507-847-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL A ROGGOW DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROGGOW",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "507-847-3910",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "9644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Jackson, MN
• Providers in Jackson, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.