Troy Roeder DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19023696 Issued in IL

Legal business name

TROY ROEDER DDS PC

Practice address

5030 38TH Ave
Suite 1
Moline, IL 61265-6717

Phone

(309) 762-1602

Fax

(309) 762-1772

NPI assigned

Feb 3, 2012

Last updated

Feb 3, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Troy J Roeder, DDSNPI 1811059413

Title

Doctor/Owner

Phone

(309) 762-1602

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Troy James Roeder, DDS

  • Dentist
  • Moline, IL
  • NPI 1811059413
  NPD (past) Authorized official

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328227200000",
    "number": "1881966042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 38TH AVE",
            "address_2": "SUITE 1",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656717",
            "telephone_number": "309-762-1602",
            "fax_number": "309-762-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 38TH AVE",
            "address_2": "SUITE 1",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656717",
            "telephone_number": "309-762-1602",
            "fax_number": "309-762-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TROY ROEDER DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-03",
        "last_updated": "2012-02-03",
        "status": "A",
        "authorized_official_last_name": "ROEDER",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "309-762-1602",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19023696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trinity Visiting Nurse and Homecare Association (Trinity Pathway Hospice)
• Trinity Visiting Nurse and Homecare Association
• Trinity Visiting Nurse and Homecare Association
• Trinity Visiting Nurse and Homecare Association
• Christine M Troxell, AUD
• Moe Phyu Tun, D.O.
• Melvin Turner III, H.I.S.
• Michael A Turner, MD
• Twin Rivers Physical Therapy, PC
• Two Rivers Pediatric Dentistry, L.L.C.

• General Practice Dentistry in Moline, IL
• Providers in Moline, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; 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.