DR. KENNETH S ROTSKOFF (NPI# 1578777280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578777280 |
Entity Type | Individual |
Full Name | DR. KENNETH S ROTSKOFF |
Credential | MD,DDS |
Practice Address |
1034 S Brentwood Blvd Suite 1010 Saint Louis MO 63117-1223 |
Practice Telephone | 3147211010 |
Mailing Telephone | 3147211010 |
Enumeration Date | 2007-05-10 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgery | 011149 | MO | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | DENTAL LICENSE | 011149 | 01 |
Street Address |
1034 S BRENTWOOD BLVD SUITE 1010 |
City | SAINT LOUIS |
State | MO |
Zip Code | 63117-1223 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720082233 | Levi S Kirkland Jr. | Surgery | 1034 S Brentwood Blvd, Suite 694, Saint Louis, MO 63117-1223 | 2005-06-13 |
1770028953 | Christina Cammon | Nurse Practitioner | 1034 S Brentwood Blvd, Suite 516, Saint Louis, MO 63117-1223 | 2016-12-27 |
1396289468 | Natalie Beth Antin | Social Worker | 1034 S Brentwood Blvd, Suite 555, Saint Louis, MO 63117-1223 | 2016-12-08 |
1417490772 | Patrick Alan Behnke | Nurse Practitioner | 1034 S Brentwood Blvd, Suite 600, Saint Louis, MO 63117-1223 | 2016-11-18 |
1457803611 | St Louis Trauma Counseling LLC | Social Worker | 1034 S Brentwood Blvd, Suite 555, Saint Louis, MO 63117-1223 | 2016-11-03 |
1912459439 | 360 Health Care, LLC | In Home Supportive Care | 1034 S Brentwood Blvd, Suite 450a, Saint Louis, MO 63117-1223 | 2016-11-01 |
1083162416 | John Petrovich | Specialist | 1034 S Brentwood Blvd, Suite 450a, Saint Louis, MO 63117-1223 | 2016-09-14 |
1609320076 | Allyson Graves | Speech-Language Pathologist | 1034 S Brentwood Blvd, #300, Saint Louis, MO 63117-1223 | 2016-08-15 |
1609237718 | Christine Shore-fitzgerald | Social Worker | 1034 S Brentwood Blvd, Suite 555, Saint Louis, MO 63117-1223 | 2016-03-16 |
1164883518 | St. Louis Dbt, LLC | Social Worker | 1034 S Brentwood Blvd, Suite 555, Saint Louis, MO 63117-1223 | 2016-03-13 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
1265917025 | Blue Stars Therapy, LLC | Occupational Therapist | 1101 Edward Terrace, Apt A, St. Louis, MO 63117 | 2018-09-27 |
1770060014 | Ultra Care Home Services LLC | Home Health | 7353 Dale Ave, Saint Louis, MO 63117 | 2018-07-19 |
1235623562 | Melissa Valerie Taylor | Counselor | Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 | 2018-06-20 |
1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
Find all providers in zip 63117 |
Taxonomy Code | 204E00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Oral & Maxillofacial Surgery |
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790849834 | Edward Steven Czebrinski | Oral & Maxillofacial Surgery | 77 Westport Plaza Medical Center, Suite 356, Saint Louis, MO 63146 | 2006-12-21 |
1376607416 | Edward S Czebrinski Dmd PC | Oral & Maxillofacial Surgery | 77 Westport Plaza Medical Center, Suite 356, Saint Louis, MO 63146 | 2006-12-21 |
1063435089 | William D Gay | Oral & Maxillofacial Surgery | 517 S Euclid Ave, 8th Floor, Saint Louis, MO 63110-1007 | 2006-07-25 |
1801885314 | Allen Sclaroff | Oral & Maxillofacial Surgery | 1 Barnes Jewish Hospital Plz, Suite 16432, Saint Louis, MO 63110-1003 | 2005-10-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609162189 | Rebecca Lindsay Grammer | Oral & Maxillofacial Surgery | 1034 S. Brentwood, Suite 1010, St. Louis, MO 63117-1210 | 2011-06-23 |
1659538973 | Michael J Pernoud Dds PC | Oral & Maxillofacial Surgery | 1015 Washington Sq Ste F, Washington, MO 63090-5307 | 2008-05-22 |
1912173592 | John O'connor Heiman | Oral & Maxillofacial Surgery | 4545 Wornall Rd, # 608, Kansas City, MO 64111-3270 | 2008-05-05 |
1730222647 | Matthew W Sheffer | Oral & Maxillofacial Surgery | 5227 S Main St Ste B, Joplin, MO 64804-4938 | 2007-02-14 |
1558415075 | Roberet L Ward | Oral & Maxillofacial Surgery | 1325 N Mt Auburn Rd, Cape Giraedeau, MO 63701 | 2007-01-22 |
1063593838 | Eugenio G Herbosa | Oral & Maxillofacial Surgery | 12818 Tesson Ferry Road, Suite 204, St Louis, MO 63128 | 2006-10-18 |
1912019290 | David M Ivey Dds PC | Oral & Maxillofacial Surgery | One Mid Rivers Mall Dr, Ste 310, St Peters, MO 63376-4323 | 2006-08-31 |
1285017806 | Marion Harris | Oral & Maxillofacial Surgery | 2301 Holmes St, Kansas City, MO 64108-2640 | 2015-06-30 |
1851618847 | Aosdi, Glenn J Makowski, Dmd, Md, PC | Oral & Maxillofacial Surgery | 2602 Cunningham Ave, Joplin, MO 64804-1542 | 2010-04-29 |
1699901868 | Thaer Daifallah | Oral & Maxillofacial Surgery | 2301 Holmes St, Kansas City, MO 64108-2640 | 2009-06-02 |
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City | SAINT LOUIS |
Zip Code | 63117 |
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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.