Roberta Rita Jurash, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53001 Issued in CA

Practice address

411 4TH St
Marin County Dental Services
San Rafael, CA 94901-5716

Phone

(415) 473-5450

NPI assigned

Jul 17, 2007

Last updated

Jul 17, 2007By 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

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.

Opted out of Medicare

Yes, effective Jul 24, 2023 through Jul 24, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: rjurash335764@direct-ucsfmedicalcenter.org

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1871792937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 4TH STREET",
            "address_2": "MARIN COUNTY DENTAL SERVICES",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "94901",
            "telephone_number": "415-473-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 4TH ST",
            "address_2": "MARIN COUNTY DENTAL SERVICES",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949015716",
            "telephone_number": "415-473-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURASH",
        "first_name": "ROBERTA",
        "middle_name": "RITA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jennifer C Jung, RD
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• General Practice Dentistry in San Rafael, CA
• Providers in San Rafael, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.