Individual provider Active NPI

Rools Dessieux, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Waterbury, CT
National Provider Identifier
1700936580
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
013310 Issued in CT
Practice address
133 Scovill St
Suite 209
Waterbury, CT 06706-1253
Phone
(203) 709-7055
Fax
(203) 709-7750
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 013310 GA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 013310 CT Primary

Addresses

Primary practice location

133 Scovill St
Suite 209
Waterbury, CT 06706-1253

Mailing address

56 Franklin St.
3Rd Floor
Waterbury, CT 04706-1253
Phone (203) 709-8879

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

State licenses

LicenseStateTypeSpecialty
013310CTMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin Medical Group, PC Past Accepting new patients
Johnson Ferry Dentistry, PC Past Accepting new patients
North Decatur Dentistry, PC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1700936580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST.",
            "address_2": "3RD FLOOR",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "047061253",
            "telephone_number": "203-709-8879",
            "fax_number": "203-709-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 SCOVILL ST",
            "address_2": "SUITE 209",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061253",
            "telephone_number": "203-709-7055",
            "fax_number": "203-709-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESSIEUX",
        "first_name": "ROOLS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "013310",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "013310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.