Rozensky Ilkka and Associates PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ROZENSKY ILKKA AND ASSOCIATES PA

Doing business as

Southern Trace Dental

Practice address

3495 Wedgewood LN
The Villages, FL 32162-7184

Phone

(352) 751-5777

Fax

(352) 751-5014

NPI assigned

May 9, 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

Linda Keever Higgs

Title

Office Manager

Phone

(352) 751-5777

Specialties & licenses 1

Addresses

Other names 1

• Southern Trace Dental Doing business as

Locations

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780898817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 WEDGEWOOD LN",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321627184",
            "telephone_number": "352-751-5777",
            "fax_number": "352-751-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 WEDGEWOOD LN",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321627184",
            "telephone_number": "352-751-5777",
            "fax_number": "352-751-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROZENSKY ILKKA AND ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HIGGS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "KEEVER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "352-751-5777"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Trace Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anna-Marie M Roswold, ARNP
• Mark A Rothschild, MD
• Susan M Roy, LCSW
• Royal Palm Beach Rehab Corp (Action Physical Therapy)
• Royal Palm Beach Rehab Corp (Action Physical Therapy)
• Richard W Rozensky, DDS
• Shaun Matthew Rudi, CRNA
• Phillip Paul Ruppert, PSYD
• Tara Piner Rushing, APRN
• Amanda Kathleen Russ, DNP, APRN

• General Practice Dentistry in The Villages, FL
• Providers in The Villages, FL by specialty
• General Practice Dentistry in Florida

• 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.