Jordana Rothenberg, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

063511-01 Issued in NY

Practice address

415 W Merrick Rd
Freeport, NY 11520-4144

Phone

(516) 378-1415

NPI assigned

May 18, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1992379481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W MERRICK RD",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115204144",
            "telephone_number": "516-378-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W MERRICK RD",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115204144",
            "telephone_number": "516-378-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHENBERG",
        "first_name": "JORDANA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-18",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "063511-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rocio Romero
• Phana Romulus, LPN
• Regla C Rosario
• Leslie April Rosen, MS RD CDN
• Lisa P. Rosenzweig, M.S. C.C.C.-SLP
• Heather J Rotter, LCSW
• Antonio Ruberto Jr., LMSW
• Stephie Ruiz, ESTHETICIAN
• Mary Magdalene Russell Lewis, RN
• Danielle Sagi, RN

• General Practice Dentistry in Freeport, NY
• Providers in Freeport, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.