Katherine Anderson Roth, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

4459-24 Issued in MS

Practice address

306 Fountains Dr
Madison, MS 39110-6384

Phone

(601) 605-1410

NPI assigned

Jun 5, 2024

Last updated

Jun 5, 2024By the provider in NPPES

Sex

Female

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• LD-Madison, LLC

  dba Colony Dental

  • Dental Clinic/Center
  • Madison, MS
  • NPI 1285415216
  NPD

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1871334573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 W TIDEWATER LN",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108928",
            "telephone_number": "662-202-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 FOUNTAINS DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106384",
            "telephone_number": "601-605-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "KATHERINE",
        "middle_name": "ANDERSON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "4459-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jannah Robinson
• Krista Johnson Robinson, DPT
• Roseworks Inc (Earthly Delights Day Spa)
• Jason Ross, DDS
• Marion Christine Ross, L.C.S.W.
• William Wade Rowland, RD, LD
• Angie Rucker, RHIA
• Benjamin Reese Rudsenske, DMD
• Natalie Ethridge Rudsenske, MD
• Nickhil Rugnath

• Dentist in Madison, MS
• Providers in Madison, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.