Individual provider Active NPI

Christopher C Rocheleau, DMD

  • Dentist
  • Mesa, AZ
National Provider Identifier
1801466503
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D011084 Issued in AZ
Practice address
1830 S Alma School Rd Ste 110
Mesa, AZ 85210-3086
Phone
(480) 834-1317
NPI assigned
Jun 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D011084 AZ Primary

Addresses

Primary practice location

1830 S Alma School Rd Ste 110
Mesa, AZ 85210-3086

Mailing address

400 E Earll Dr Unit 419
Phoenix, AZ 85012-0026
Phone (203) 407-9273

Other practice location 1

400 E Earll Dr Unit 419
Phoenix, AZ 85012-0026
Phone (203) 407-9273

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

LicenseStateTypeSpecialty
D011084AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Dentistry LLC PastSince Jun 27, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1801466503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E EARLL DR UNIT 419",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850120026",
            "telephone_number": "203-407-9273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 S ALMA SCHOOL RD STE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103086",
            "telephone_number": "480-834-1317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 E Earll Dr Unit 419",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850120026",
            "country_code": "US",
            "telephone_number": "203-407-9273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCHELEAU",
        "first_name": "CHRISTOPHER",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-25",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; 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.