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Deactivated NPI 1104809177 Deactivated / Inactive NPI Male Practitioner

Dr. Roger Pearson , DDS

Dentist - General Practice • Rockford, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Roger Pearson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 23, 2005
NPI Deactivation Date July 26, 2024
Total Practice Duration ~19 Years of Practice (2005 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Roger Pearson, DDS was a registered Dentist - General Practice practicing in Rockford, IL. Throughout an active medical career spanning 19 years, Dr. Pearson provided care at the practice location at 1200 W STATE ST until profile deactivation on 2024-07-26.

Practice Location & Contact Primary Location

Practice Address

1200 W State St

Rockford, IL 611022112

Telephone 8154901600
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Rockford, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
97 Specialists

Practicing in Rockford, IL (5581 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Caryn Ruzic , APRN

Nurse Practitioner - Family

NPI 1003572660

Advanced Practice Registered Nurse

Dr. John Wall , MD

Family Medicine

NPI 1003899071

Doctor of Medicine (M.D.)

Dr. Adekola Ashaye , MD

Internal Medicine

NPI 1003899162

Doctor of Medicine (M.D.)

NPI 1013188408

Doctor of Medicine (M.D.)

NPI 1013363290

Licensed Social Worker

Dr. Cornita Cannon , MD

Obstetrics & Gynecology

NPI 1013595297

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 26, 2024

Record deactivated on July 26, 2024

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 09, 2007

Registered at 1200 W STATE ST, ROCKFORD, IL 611022112 (Tel: 8154901600)

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Updated Business Mailing Address July 09, 2007

Registered at 1312 CREEKWOOD CIR, ROCKFORD, IL 611081531 (Tel: 8153980596)

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Provider Name / Credentials Updated July 09, 2007

Recorded as ROGER PEARSON, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Dentist

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Initial NPI Registration & Enumeration November 23, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104809177
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 23, 2005
Last Update: July 09, 2007
Deactivation Date: July 26, 2024

Mailing Address

1312 Creekwood Cir

Rockford, IL 611081531

Phone: 8153980596

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.