John David Roush, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9675 Issued in MI

Practice address

540 Michigan Avenue
Holland, MI 49423

Phone

(616) 396-7490

Fax

(616) 396-3766

NPI assigned

Aug 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Hilary M Lane, DDS Family Dentistry

  • Dental Clinic/Center
  • Holland, MI
  • NPI 1992431696
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790798148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 MICHIGAN AVENUE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49423",
            "telephone_number": "616-396-7490",
            "fax_number": "616-396-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 MICHIGAN AVENUE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49423",
            "telephone_number": "616-396-7490",
            "fax_number": "616-396-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSH",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "9675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4005720",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Ann Rosendahl
• Madison Roskuszka
• Sandy Ross
• Anne Kathleen Rothenbach, PT
• Kayla Danielle Rotman
• Brianne Ilyse Roux, LPC
• Lydia Roy
• Rebecca Lynn Rozema, LMSW
• Katelyn Ruch
• Caleb Charles Rudd, MA, LPC

• General Practice Dentistry in Holland, MI
• Providers in Holland, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.