Jonathan Roberts, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

034632 Issued in NY

Practice address

501 Madison Ave
New York, NY 10022-5602

Phone

(212) 758-9690

Fax

(212) 838-1137

NPI assigned

Jan 14, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1326499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326499200000",
    "number": "1861763310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225602",
            "telephone_number": "212-758-9690",
            "fax_number": "212-838-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225602",
            "telephone_number": "212-758-9690",
            "fax_number": "212-838-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-14",
        "last_updated": "2012-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "034632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Y Roberts, LCSW
• Jeremy Roberts, MD
• Joenine Elena Roberts, L.M.S.W., L.P.
• John Lawson Roberts
• John Lucas Roberts III, L.M.T., L.AC.
• Kailey Roberts, PHD
• Keasha Roberts
• Kyla Elizabeth Roberts, PA-C
• Lauren Elizabeth Roberts, MD
• Leslie Elaine Roberts, LMSW

• Dentist in New York, NY
• Providers in New York, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.