Active NPI
Aaron Legrand Roberts, D.M.D.
- Dental Anesthesiology
- Mesa, AZ
National Provider Identifier
1972864528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Anesthesiology
- License
- D009441
- Practice address
- 625 W Southern Ave
Ste E-145
Mesa, AZ 85210-5030 - Phone
- (602) 513-2242
- NPI assigned
- May 30, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Anesthesiology | 1223D0004X | D009441 | AZ | Primary |
| Dental Anesthesiology | 1223D0004X | 31819 | TX |
Addresses
Primary practice location
625 W Southern Ave
Ste E-145
Mesa, AZ 85210-5030
Mailing address
PO Box 11765
Glendale, AZ 85318-1765
Phone (602) 513-2242
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 |
|---|---|---|---|
| D009441 | AZ | MD | Dentist Anesthesiologist |
| 31819 | TX | MD | Dentist Anesthesiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467849600000",
"number": "1972864528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11765",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853181765",
"telephone_number": "602-513-2242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 W SOUTHERN AVE",
"address_2": "STE E-145",
"city": "MESA",
"state": "AZ",
"postal_code": "852105030",
"telephone_number": "602-513-2242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "AARON",
"middle_name": "LEGRAND",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-30",
"last_updated": "2016-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0004X",
"taxonomy_group": "",
"desc": "Dentist, Dental Anesthesiology",
"state": "AZ",
"license": "D009441",
"primary": true
},
{
"code": "1223D0004X",
"taxonomy_group": "",
"desc": "Dentist, Dental Anesthesiology",
"state": "TX",
"license": "31819",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.