Provider Demographics
NPI:1982708335
Name:ROTHAN, ROBERT JULIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JULIAN
Last Name:ROTHAN
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 1:962 LAKE SHORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-2552
Mailing Address - Country:US
Mailing Address - Phone:513-521-0559
Mailing Address - Fax:
Practice Address - Street 1:944 HEMPSTEAD DRIVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-5914
Practice Address - Country:US
Practice Address - Phone:513-521-7250
Practice Address - Fax:513-728-7733
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11681122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist