MARY K. ROTH D.D.S. PC (NPI# 1699976902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699976902 |
| Entity Type | Organization |
| Organization Name | MARY K. ROTH D.D.S. PC |
| Practice Address |
807 Saint Andrew St Rapid City SD 57701-4526 |
| Practice Telephone | 6053439352 |
| Practice Fax Number | 6053433115 |
| Mailing Telephone | 6053439352 |
| Mailing Fax Number | 6053433115 |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2008-06-10 |
| Authorized Official Name | MRS. MARY KAY ROTH (DOCTER) |
| Authorized Official Telephone | 6053439352 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
M697 | SD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 7805870 | 05 | |
| SD | OTHER | BR1122302 | 01 |
| Street Address |
807 SAINT ANDREW ST |
| City | RAPID CITY |
| State | SD |
| Zip Code | 57701-4526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871830851 | Kate Haave, Dds, PC | Dentist | 807 Saint Andrew St, Rapid City, SD 57701-4526 | 2013-01-10 |
| 1124337787 | Roth Haave LLC | Dentist | 807 Saint Andrew St, Rapid City, SD 57701-4526 | 2010-09-30 |
| 1437319613 | Kate Suzanne Haave | Dentist | 807 Saint Andrew St, Rapid City, SD 57701-4526 | 2008-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528623345 | Julie Maas | Counselor | 625 1/2 Main St, Suite 1, Rapid City, SD 57701 | 2019-05-07 |
| 1972076024 | Edgewood Rapid City LLC | Assisted Living Facility | 4001 Derby Lane, Rapid City, SD 57701 | 2019-01-10 |
| 1902300247 | Theresa Gibbens | Speech-Language Pathologist | 3301 Grandview Drive, Rapid City, SD 57701 | 2018-03-21 |
| 1407355423 | Arielle Leigh Loveridge | Chiropractor | 610 East Boulevard, Suite 1, Rapid City, SD 57701 | 2018-02-05 |
| 1083125082 | Sarah Kirschman | Nurse Practitioner | 353 Fairmont Boulvevard, Rapid City, SD 57701 | 2017-10-17 |
| 1992225239 | Kelsey Elizabeth Wondercheck | Dentist | 717 Meade Street, Suite 200, Rapid City, SD 57701 | 2017-06-27 |
| 1316476088 | Rhianna Wickett | Physical Therapist | 420 E Saint Patrick St Ste 101, Rapid City, SD 57701 | 2017-06-07 |
| 1841727773 | Cynthia A Gates | Dietitian, Registered | 2908 5th Street, Rapid City, SD 57701 | 2017-05-23 |
| 1811447758 | Alyssa Marquardt | Psychologist | 433 Mt. Rushmore Road, Rapid City, SD 57701 | 2016-10-04 |
| 1578913232 | .indian Health Service | Clinic/Center | 241 East Meade St, Rapid City, SD 57701 | 2016-06-14 |
| Find all providers in zip 57701 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508403957 | Black Hills Modern Endodontics | Clinic/Center | 655 Omaha St Ste 400, Rapid City, SD 57701-2744 | 2019-12-04 |
| 1023660719 | Dakota Dental 4 Kids | Clinic/Center | 5509 Bendt Dr Ste 302, Rapid City, SD 57702-9460 | 2019-07-12 |
| 1578913232 | .indian Health Service | Clinic/Center | 241 East Meade St, Rapid City, SD 57701 | 2016-06-14 |
| 1275131013 | Elden M Rice Dds PC | Clinic/Center | 3712 Canyon Lake Dr, Rapid City, SD 57702-3198 | 2020-10-14 |
| 1962054643 | Rapid City Dental Clinic | Clinic/Center | 2525 W Main St Ste 304, Rapid City, SD 57702-2487 | 2019-07-12 |
| 1205393394 | Black Hills Orthodontics, Prof. L.L.C. | Clinic/Center | 5150 5th St, Rapid City, SD 57701-6023 | 2019-02-25 |
| 1386092674 | Reausaw-wilson, Dmd, P.C. | Clinic/Center | 4215 Berniece St, Rapid City, SD 57703-6410 | 2016-05-27 |
| 1952768186 | Michael H Doerr, D.m.d., P.C. | Clinic/Center | 801 Mount Rushmore Rd, Suite 201, Rapid City, SD 57701-3614 | 2016-01-19 |
| 1831576875 | Joshua W Nehring Dds, PC | Clinic/Center | 2800 Jackson Blvd Ste 6, Rapid City, SD 57702-3477 | 2015-04-29 |
| 1356733042 | Eric Wilbur Dmd PC | Clinic/Center | 211 Founders Park Dr, Suite 2, Rapid City, SD 57701-8098 | 2015-03-04 |
| Find all providers in RAPID CITY | ||||
| City | RAPID CITY |
| Zip Code | 57701 |
Please comment or provide details below to improve the information on MARY K. ROTH D.D.S. PC.
| 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.