Susan Elizabeth Roberts, D.D.S., M.S.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DE00010281 Issued in WA

Practice address

555 S Renton Village PL
Ste 786
Renton, WA 98057-3294

Phone

(425) 207-8677

NPI assigned

Dec 5, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Advanced Endodontics

  • Endodontics
  • Renton, WA
  • NPI 1184563975
  NPD (past)

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

{
    "created_epoch": "1291507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291507200000",
    "number": "1720381254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S RENTON VILLAGE PL STE 786",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573294",
            "telephone_number": "425-996-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S RENTON VILLAGE PL",
            "address_2": "STE 786",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573294",
            "telephone_number": "425-207-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-05",
        "last_updated": "2010-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE00010281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert K. Sekijima, DDS,Ms,PS
• Chika Roberts, L.M.P.
• Christopher Jon Roberts, B.C.B.A.
• Joseph Rootjes Roberts, MD
• Patricia Roberts
• Taylor Roberts
• Ashton Adia Robertson, DNP, ARNP, PHMNP-BC
• Gayle Robinson, RN
• Heather D Robinson, LMP
• Jessica Robinson, DMD

• Endodontics in Renton, WA
• Providers in Renton, WA by specialty
• Endodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2010; 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.