Active NPI
Maria Roque
- Dentist
- Elkhorn, WI
National Provider Identifier
1780363432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6001426-15
- Practice address
- 220 E Commerce CT Ste a
Elkhorn, WI 53121-4371 - Phone
- (262) 723-3224
- NPI assigned
- Jul 11, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6001426-15 | WI | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
220 E Commerce CT Ste a
Elkhorn, WI 53121-4371
Mailing address
1105 S 32ND St
Milwaukee, WI 53215-1553
Phone (143) 646-5304
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6001426-15 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745798400000",
"number": "1780363432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 S 32ND ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532151553",
"telephone_number": "143-646-5304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 E COMMERCE CT STE A",
"city": "ELKHORN",
"state": "WI",
"postal_code": "531214371",
"telephone_number": "262-723-3224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROQUE",
"first_name": "MARIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-11",
"last_updated": "2025-04-28",
"certification_date": "2025-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "6001426-15",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhorn, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.