Paul R Rockoff, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

4190 Issued in CT

Practice address

3715 Main St
Suite 302
Bridgepoint, CT 06606

Phone

(203) 372-5566

Fax

(203) 374-9989

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831209212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 MAIN ST",
            "address_2": "SUITE 302",
            "city": "BRIDGEPOINT",
            "state": "CT",
            "postal_code": "06606",
            "telephone_number": "203-372-5566",
            "fax_number": "203-374-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 MAIN ST",
            "address_2": "SUITE 302",
            "city": "BRIDGEPOINT",
            "state": "CT",
            "postal_code": "06606",
            "telephone_number": "203-372-5566",
            "fax_number": "203-374-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCKOFF",
        "first_name": "PAUL",
        "middle_name": "R",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CT",
            "license": "4190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 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.