BRAD WARREN ROEHL DMD NPI 1902829161

NPI Information

  • NPI: 1902829161
  • Provider Name: BRAD WARREN ROEHL, DMD
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Individual
  • Address: 435 ARROWHEAD BLVD
    JONESBORO, GA
    ZIP 30236
  • Phone: (770) 478-8400

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NPI Details

Brad Warren Roehl, DMD is a pediatric dentistry dentist in Jonesboro, GA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. Brad Warren Roehl, DMD NPI is 1902829161. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

435 ARROWHEAD BLVD
JONESBORO, GA
ZIP 30236-219
Phone: (770) 478-8400
Fax: (770) 473-8766

The enumeration date for this NPI number is 7/26/2006 and was last updated on 8/24/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0221XDentistPediatric DentistryDN012958GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1280155184BMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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