Active NPI
Beatriz De la Roche, D.M.D
- Pediatric Dentistry
- Mt Pleasant, PA
National Provider Identifier
1942429931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DS030164L
- Practice address
- 6583 Route 819 S
Suite 1
Mount Pleasant, PA 15666-3503 - Phone
- (724) 542-4818
- Fax
- (724) 542-4828
- NPI assigned
- Apr 25, 2007
- Last updated
- Dec 13, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DS030164L | PA | Primary |
Addresses
Primary practice location
6583 Route 819 S
Suite 1
Mount Pleasant, PA 15666-3503
Mailing address
6583 Route 819 S
Suite 1
Mount Pleasant, PA 15666-3503
Phone (724) 542-4818
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000271462 | Other | PA | UNITED CONCORDIA |
| 2443009 | Other | PA | AETNA DENTAL |
| 000000191199 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS030164L | PA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tender Care Pediatric Dentistry LLC | Pediatric Dentistry | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatric Dentistry
- Mt Pleasant, PA
- NPI 1043339476
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323734400000",
"number": "1942429931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6583 ROUTE 819 S",
"address_2": "SUITE 1",
"city": "MOUNT PLEASANT",
"state": "PA",
"postal_code": "156663503",
"telephone_number": "724-542-4818",
"fax_number": "724-542-4828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6583 ROUTE 819 S",
"address_2": "SUITE 1",
"city": "MOUNT PLEASANT",
"state": "PA",
"postal_code": "156663503",
"telephone_number": "724-542-4818",
"fax_number": "724-542-4828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LA ROCHE",
"first_name": "BEATRIZ",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2011-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "PA",
"license": "DS030164L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "000271462",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA DENTAL",
"identifier": "2443009",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000000191199",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mt Pleasant, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.