Individual provider Active NPI

Daniel Joseph Rovelstad, D.M.D.

  • Dentist
  • Cincinnati, OH
National Provider Identifier
1891769352
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30024099 Issued in OH
Practice address
8340 Colerain Ave
Cincinnati, OH 45239
Phone
(513) 385-5999
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019-025936 IL
Dentist 122300000X 30024099 OH Primary

Addresses

Primary practice location

8340 Colerain Ave
Cincinnati, OH 45239

Mailing address

8340 Colerain Ave
Cincinnati, OH 45239-3916
Phone (513) 385-5999

Other practice location 1

6215 E State St
Rockford, IL 61108-2514
Phone (815) 399-7777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20160407002180 OH Order and Referring Only - DentistPractitioner - Dentist 0840598801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-025936ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Experts, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1891769352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8340 COLERAIN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452393916",
            "telephone_number": "513-385-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8340 COLERAIN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45239",
            "telephone_number": "513-385-5999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6215 E State St",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611082514",
            "country_code": "US",
            "telephone_number": "815-399-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROVELSTAD",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-025936",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30024099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.