Kenneth Sherman Roll, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

033037 Issued in NY

Practice address

130 N Front St
Suite #8
Kingston, NY 12401-3741

Phone

(845) 338-8812

Fax

(845) 338-9086

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DE

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

Specialty

Oral Surgery

Education

New York University College of Dentistry, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christiana Hospital Hospital, Newark, DE, CCN 080001

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Christiana Care Health Services Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Wilmington, DE
  • NPI 1194073411
  Medicare reassignment Care Compare group NPD
• Christiana Care Health Services Inc

  • Neurology Physician
  • Chadds Ford, PA
  • NPI 1881228484
  NPD
• Christiana Care Health Services, Inc

  • Family Medicine Physician
  • Hockessin, DE
  • NPI 1134104565
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christiana Care Health Services, Inc.

  • General Acute Care Hospital
  • Wilmington, DE
  • NPI 1134194038
  Care Compare affiliation

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276041600000",
    "number": "1912949934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 N FRONT ST",
            "address_2": "SUITE #8",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013741",
            "telephone_number": "845-338-8812",
            "fax_number": "845-338-9086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N FRONT ST",
            "address_2": "SUITE #8",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013741",
            "telephone_number": "845-338-8812",
            "fax_number": "845-338-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLL",
        "first_name": "KENNETH",
        "middle_name": "SHERMAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2010-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "033037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00636728",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rockland Chiropractic and Physical Therapy PLLC
• Paul Evan Rode, RPH
• Sandra Rodier
• Timothy John Rodier, LCSW-R
• Molly Catherine Rogerson, MA, CCC-SLP
• Brandon James Roman, LMHC
• Wendy M Roosa, RD, CDN
• Sue Rosenberg, LCSW-R
• Patti Ruth Rosenbloom, LCSWR CASAC
• Madeline Joy Rosensweet, LCSW

• Oral and Maxillofacial Surgery (Dentist) in Kingston, NY
• Providers in Kingston, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.