1518212083 NPI number — DR. MEGAN R ROHMAN D.D.S.

Table of content: DR. MEGAN R ROHMAN D.D.S. (NPI 1518212083)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518212083 NPI number — DR. MEGAN R ROHMAN D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROHMAN
Provider First Name:
MEGAN
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DANFORTH
Provider Other First Name:
MEGAN
Provider Other Middle Name:
R
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.D.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1518212083
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/20/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2624 GRAND AVE STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENWOOD SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81601-4676
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-335-7440
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2624 GRAND AVE STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLENWOOD SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-928-7467
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/19/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X , with the licence number:  30456 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: 201816 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)