Active NPI
Christine Roenitz
- Prosthodontics
- Monona, WI
National Provider Identifier
1851867261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 1002460-15
- Practice address
- 612 River PL
Monona, WI 53716-4034 - Phone
- (608) 222-6606
- NPI assigned
- Oct 23, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7496 | NE | |
| Prosthodontics | 1223P0700X | 1002460-15 | WI | Primary |
Addresses
Primary practice location
612 River PL
Monona, WI 53716-4034
Mailing address
612 River PL
Monona, WI 53716-4034
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1002460-15 | WI | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681257600000",
"number": "1851867261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 RIVER PL",
"city": "MONONA",
"state": "WI",
"postal_code": "537164034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 RIVER PL",
"city": "MONONA",
"state": "WI",
"postal_code": "537164034",
"telephone_number": "608-222-6606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROENITZ",
"first_name": "CHRISTINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-23",
"last_updated": "2023-04-12",
"certification_date": "2023-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NE",
"license": "7496",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "WI",
"license": "1002460-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monona, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.