Timothy Roettger

Primary specialty

DentistTaxonomy code 122300000X

License

DDS100239 Issued in CA

Practice address

1955 Central Ave
McKinleyville, CA 95519-3605

Phone

(707) 839-1100

NPI assigned

Jul 17, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Timothy Roettger DMD Inc

  dba Central Dental Care

  • Dental Clinic/Center
  • McKinleyville, CA
  • NPI 1326562190
  NPD Authorized official

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861876062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 CENTRAL AVE",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955193605",
            "telephone_number": "707-839-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 CENTRAL AVE",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955193605",
            "telephone_number": "707-839-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "618 W Pierce Steet",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "NM",
            "postal_code": "88220",
            "country_code": "US",
            "telephone_number": "575-885-3948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROETTGER",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD4352",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS100239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Jean Reeves, LCSW
• Andrew Thomas Richey I, BACHELOR OF SCIENCE
• Marc Riggins Jr.
• Zachary Michael Roberts, LCSW
• Daniel Scott Robinson, RN
• Sarah Brooke Romero Pavon, M. A., BCBA
• Spencer Ian Ross
• Phillip K Ruprecht, O.D.
• S. Shaun Johanson DDS, Inc.
• Elwira Salata

• Dentist in McKinleyville, CA
• Providers in McKinleyville, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.