Roberts Dental Group LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ROBERTS DENTAL GROUP LLC

Practice address

3415 S Lafountain St Ste I
Kokomo, IN 46902-3826

Phone

(765) 455-1222

Fax

(765) 455-0485

NPI assigned

Jan 13, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Justin Levi Roberts, DDSNPI 1699065862

Title

Owner

Phone

(765) 455-1222

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Justin L Roberts, D.D.S.

  • Dentist
  • Kokomo, IN
  • NPI 1699065862
  NPD Authorized official
• Eric Gerald Hollensbe, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Hutchinson, KS
  • NPI 1689282196

  General Practice

  NPD (past)

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1811601800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 S LAFOUNTAIN ST STE I",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023826",
            "telephone_number": "765-455-1222",
            "fax_number": "765-455-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 S LAFOUNTAIN ST STE I",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023826",
            "telephone_number": "765-455-1222",
            "fax_number": "765-455-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTS DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "LEVI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-455-1222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nader M Rizk
• Sherese Marie Rizo
• Cale Roark
• Samantha Dawn Roark
• Robert a. Clements, D.C., P.C.
• Amanda Roberts, PMHNP
• Justin L Roberts, D.D.S.
• Lindsey Carol Roberts, FNP
• Paul Joseph Roberts, PH.D.
• Lori Annette Robertson, LCSW, LCAC

• General Practice Dentistry in Kokomo, IN
• Providers in Kokomo, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.