Alex Reza Roelens

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

102129 Issued in CA

Practice address

8430 Lemon Ave
La Mesa, CA 91941

Phone

(619) 466-8363

NPI assigned

Mar 1, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Stephen B Earle, DDS

  • General Practice Dentistry
  • La Mesa, CA
  • NPI 1629093570
  NPD (past)

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

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1972005429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26096 N 74TH AVE UNIT 2319",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92101",
            "telephone_number": "623-521-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8430 LEMON AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91941",
            "telephone_number": "619-466-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROELENS",
        "first_name": "ALEX",
        "middle_name": "REZA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-01",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loralisa M Rocca, LCSW
• Linda Kristen Rod, FNP
• Norja Norvette Rodman, PT
• Briana C Rodriguez, PSYD
• Roseanne April Rodriguez, LCSW
• Roger L. Sur, M.D., Inc.
• Lori Louise Rogers, DDS
• Rokay Kamyar, M.D. Inc.
• Michael Christopher Rolan I
• Roman B Cham MD Inc

• General Practice Dentistry in La Mesa, CA
• Providers in La Mesa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; 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.