Individual provider Active NPI

Robert John Roehrig, DDS

  • General Practice Dentistry
  • Roschester Hills, MI
National Provider Identifier
1861506990
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12208 Issued in MI
Practice address
245 Barclay Circle
Suite 900
Roschester Hills, MI 48307-5809
Phone
(248) 852-6430
Fax
(248) 852-7703
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12208 MI Primary

Addresses

Primary practice location

245 Barclay Circle
Suite 900
Roschester Hills, MI 48307-5809

Mailing address

245 Barclay Circle
Suite 900
Roschester Hills, MI 48307-5809
Phone (248) 852-6430

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
12208MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Generations Dental Past 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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861506990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 BARCLAY CIRCLE",
            "address_2": "SUITE 900",
            "city": "ROSCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075809",
            "telephone_number": "248-852-6430",
            "fax_number": "248-852-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 BARCLAY CIRCLE",
            "address_2": "SUITE 900",
            "city": "ROSCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075809",
            "telephone_number": "248-852-6430",
            "fax_number": "248-852-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEHRIG",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "12208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • 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.