Provider Demographics
NPI:1528008513
Name:ROGAT, JEROLD JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEROLD
Middle Name:JAMES
Last Name:ROGAT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5564 WILSON MILLS RD
Mailing Address - Street 2:#203
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3265
Mailing Address - Country:US
Mailing Address - Phone:440-461-0203
Mailing Address - Fax:440-461-0450
Practice Address - Street 1:5564 WILSON MILLS RD
Practice Address - Street 2:#203
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-3265
Practice Address - Country:US
Practice Address - Phone:440-461-0203
Practice Address - Fax:440-461-0450
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30152081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice