Robert K Meckstroth, D.D.S

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

2901022115 Issued in MI

Practice address

70 Stony Point Rd. St.E
Santa Rosa, CA 95401-4460

Phone

(707) 575-9200

Fax

(707) 575-4546

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Mishel Malhotra DMD Dental Corp

  • General Practice Dentistry
  • Santa Rosa, CA
  • NPI 1912690140
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1770623969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 PROGRESS ST STE E",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486619383",
            "telephone_number": "866-878-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 STONY POINT RD. ST.E",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014460",
            "telephone_number": "707-575-9200",
            "fax_number": "707-575-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MECKSTROTH",
        "first_name": "ROBERT",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "D1036395",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "36395",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MI",
            "license": "2901022115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrienne Marjorie Mead
• Shelby L. Means
• Jared D Mearida, MPT
• Ari Mechles, LCSW
• Gabriela Meckler, MD
• Medical Consultants of America a Professional Corporation
• Medical Support Los Angeles a Medical Corporation
• Medina & Oliva Dental PC
• Cesar Ulyces Medina, PT
• Ivan Medina

• Public Health Dentistry in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Public Health Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.