DR. STACEY BROOKE ROGERS (NPI# 1275145013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275145013 |
| Entity Type | Individual |
| Full Name | DR. STACEY BROOKE ROGERS |
| Credential | DMD |
| Practice Address |
300 Longwood Ave Boston MA 02115-5724 |
| Practice Telephone | 8455580658 |
| Mailing Telephone | 6173556571 |
| Enumeration Date | 2020-08-22 |
| Last Update Date | 2020-08-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DL14455 | MA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033621024 | Stacey Rogers | Nurse Practitioner | 2319 Manhattan Rd, Joliet, IL 60433-8605 | 2017-10-30 |
| 1144670381 | Stacey Rogers | Physical Therapy Assistant | 4560 Se International Way Ste 100, Portland, OR 97222-4628 | 2016-06-19 |
| 1811227143 | Stacey Simonson Rogers | Counselor | 5656 S 129th East Ave, Tulsa, OK 74134-6715 | 2010-01-08 |
| 1760487318 | Stacey J Rogers | Obstetrics & Gynecology | 725 Volvo Pkwy, Suite 200, Chesapeake, VA 23320-1602 | 2005-06-20 |
| Street Address |
300 LONGWOOD AVE |
| City | BOSTON |
| State | MA |
| Zip Code | 02115-5724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588667539 | Barry Grant Zallen | Pediatrics | 300 Longwood Ave, Children's Hospital, Au 105, Boston, MA 02115-5724 | 2005-05-23 |
| 1730780669 | Hannah Fraser | Registered Nurse | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-11-06 |
| 1164023776 | Hannah Brewer | Social Worker | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-11-02 |
| 1104423680 | Justin Matthias Hintze | Otolaryngology | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-10-07 |
| 1295340388 | Kathryn Theresa Moffa | Psychologist | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-15 |
| 1144835224 | Abby Elizabeth Bandi | Social Worker | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-15 |
| 1558976845 | Hilary Segar Garber | Nurse Practitioner | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-13 |
| 1063026003 | Lauren M Dilullo | Psychologist | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-08 |
| 1013521004 | Carl Britto | Student in an Organized Health Care Education/Training Program | 300 Longwood Ave, Boston, MA 02115-5737 | 2020-09-07 |
| 1760096887 | Rebecca Marie Leslie | Nurse Practitioner | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1679189112 | Tara Baxter | Orthopaedic Surgery | Boston Children's Hospital - Sports Medicine Division, 319 Longwood Avenue, Boston, MA 02115 | 2020-09-21 |
| 1053923110 | Wendy Tu | Student in an Organized Health Care Education/Training Program | 75 Francis Street Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115 | 2020-08-20 |
| 1477177335 | Nicolas Wyvekens | Student in an Organized Health Care Education/Training Program | 75 Francis Street Department of Pathology, Brigham And, Boston, MA 02115 | 2020-06-05 |
| 1669095923 | Erin Crocker | Student in an Organized Health Care Education/Training Program | Northeastern University Physician Assistant Program, 360 Huntington Avenue, Boston, MA 02115 | 2020-05-21 |
| 1033732417 | Tyler Francis Hayes | Student in an Organized Health Care Education/Training Program | Gordon Hall, Suite 213, 25 Shattuck Street, Boston, MA 02115 | 2020-05-20 |
| 1982225090 | Emily Blake | Student in an Organized Health Care Education/Training Program | 202 Robinson Hall, 360 Huntington Avenue, Boston, MA 02115 | 2020-04-29 |
| 1891315495 | Stephanie Schoch | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave., 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| 1427678093 | Meghan Miles | Student in an Organized Health Care Education/Training Program | 360 Huntington Avenue 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| Find all providers in zip 02115 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326672791 | Azza Ahmed | Dentist | 635 Albany St. G-744, Boston, MA 02118 | 2020-02-25 |
| 1215575311 | Martha Forero | Dentist | 1 Kneeland St Fl 15, Boston, MA 02111-1527 | 2019-12-19 |
| 1730660903 | Matthew Brian Harper | Dentist | 300 Longwood Ave Fl 4, Boston, MA 02115-5724 | 2018-08-27 |
| 1700387453 | Dorchester Pediatric Dentistry and Orthodontics, PC | Dentist | 1192 Blue Hill Ave Unit 1192, Boston, MA 02126-1819 | 2018-02-27 |
| 1710487079 | Huw F Thomas | Dentist | 1 Kneeland St Rm 749, Boston, MA 02111-1527 | 2018-02-13 |
| 1023539269 | Altan Kihm | Dentist | 1 Keeland St, Boston, MA 02111 | 2017-06-28 |
| 1902287915 | Nour Gowharji | Dentist | 1 Kneeland Street, Tufts School of Dental Medicine., 8th Floor, Room 842, Boston, MA 02111 | 2015-06-16 |
| 1063824464 | Maria Al Ismail | Dentist | 635 Albany St, Boston, MA 02118-2308 | 2014-05-20 |
| 1225449341 | Sara Ahmed | Dentist | 300 Longwood Ave Dental Department, Boston, MA 02115 | 2014-05-12 |
| 1952731549 | Boston University Henry M. Goldman School of Dental Medicine | Dentist | 100 E Newton St # G-200, Boston, MA 02118-2308 | 2013-11-18 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.