Roger William Neill, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

037386 Issued in NY

Practice address

90 Main St
Saranac Lake, NY 12983-5735

Phone

(518) 891-0104

Fax

(518) 891-7130

NPI assigned

May 14, 2007

Sex

Male

Sole proprietor

Yes

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801001482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 MAIN ST",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129835735",
            "telephone_number": "518-891-0104",
            "fax_number": "518-891-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 MAIN ST",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129835735",
            "telephone_number": "518-891-0104",
            "fax_number": "518-891-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEILL",
        "first_name": "ROGER",
        "middle_name": "WILLIAM",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "037386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Kathryn Monroe, MD
• Mountain Medical Pediatrics
• Mountain Medical Services
• John Douglass Murray, DDS
• Taylor Lin Nedurian, PA
• Carol Nevulis, PAC
• Lara Niles, FNP
• North Country Family Physicians
• North Country Healthy Heart Network, Inc
• North Country Home Services, Inc.

• Dentist in Saranac Lake, NY
• Providers in Saranac Lake, NY by specialty
• Dentist in New York

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.