Keith Steven Rottman, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901013501 Issued in MI

Practice address

8140 Secor Rd
Lambertville, MI 48144-8673

Phone

(734) 854-2685

Fax

(734) 854-2687

NPI assigned

Jan 1, 2007

Last updated

Dec 4, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Keith Rottman DDS PC

  • Dental Clinic/Center
  • Lambertville, MI
  • NPI 1992951594
  Authorized official Same address or phone
• DRS. Lawrence & Rottman, Inc.

  dba Stateline Oral & Maxillofacial Surgery, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Toledo, OH
  • NPI 1659538155
  NPD (past)
• Timothy M. Lawrence, DDS, Ms, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Toledo, OH
  • NPI 1528338704
  NPD (past)

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228348800000",
    "number": "1912063025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8140 SECOR RD",
            "city": "LAMBERTVILLE",
            "state": "MI",
            "postal_code": "481448673",
            "telephone_number": "734-854-2685",
            "fax_number": "734-854-2687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8140 SECOR RD",
            "city": "LAMBERTVILLE",
            "state": "MI",
            "postal_code": "481448673",
            "telephone_number": "734-854-2685",
            "fax_number": "734-854-2687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTTMAN",
        "first_name": "KEITH",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2008-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30017878",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901013501",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019018808",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0585102",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tabbitha Roderick
• Kurt M Roecker, D.O.
• Jordan Elizabeth Rogaliner, OD
• William Kristopher Roman, M.A. LPC
• Teresa M Ross, RPH
• Holly Jean Ruttan, NP-C
• Justin Ryan, FNP-C
• Jean Marie Scanlon, RN
• Brenda S Schulty, FNP-C
• Schwanger Chiropractic Offices, P.C.

• Oral and Maxillofacial Surgery (Dentist) in Lambertville, MI
• Providers in Lambertville, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; 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.