Gary Dante Rotolo

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8121 Issued in CO

Practice address

1232 Bergen Pkwy
Evergreen, CO 80439-9573

Phone

(303) 674-6070

Fax

(303) 674-6071

NPI assigned

Nov 12, 2007

Sex

Male

Sole proprietor

No

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 CO

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

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 and National Provider Directory roles.

• Evergreen Dental Partners LLP

  • Dentist
  • Evergreen, CO
  • NPI 1356621122
  NPD (past) Authorized official

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1962682567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 BERGEN PKWY",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804399573",
            "telephone_number": "303-674-6070",
            "fax_number": "303-674-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1232 BERGEN PKWY",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804399573",
            "telephone_number": "303-674-6070",
            "fax_number": "303-674-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTOLO",
        "first_name": "GARY",
        "middle_name": "DANTE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-12",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "69708533",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina Rosemellia
• Katherine Rosenblatt, LPC
• Megan E Rosenblatt
• Rebecca Lily Rosenblum, DPT
• Trevor H Roth, LCSW
• Debra Jeanne Rouse, N.D.
• Kimberly L Rozman, MSN, RN, CWON
• S & P Healing Arts, PLLC
• Terri T Sadecki, PT
• Safeway Inc

• General Practice Dentistry in Evergreen, CO
• Providers in Evergreen, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.