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Deactivated NPI 1285740332 Deactivated / Inactive NPI Male Practitioner

Dr. Roger Phillip Rundbaken , DMD

Dentist - General Practice • Holmes, PA

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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 Rundbaken has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 22, 2006
NPI Deactivation Date January 13, 2017
Total Practice Duration ~11 Years of Practice (2006 – 2017)

Professional Overview & Biography Verified Profile Summary

Dr. Roger Rundbaken, DMD was a registered Dentist - General Practice practicing in Holmes, PA. Throughout an active medical career spanning 11 years, Dr. Rundbaken provided care at the practice location at 2183 MACDADE BLVD until profile deactivation on 2017-01-13.

Practice Location & Contact Primary Location

Practice Address

2183 Macdade Blvd

Holmes, PA 19043

Telephone 6104616371
Associated Practice Facility / Clinic
🏢 Whitetoothinc Facility NPI 1891616942

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Holmes, PA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.0 Yrs
Regional Practice Density
2 Specialists

Practicing in Holmes, PA (4936 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

State License PA DS019696L

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.

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 January 13, 2017

Record deactivated on January 13, 2017

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 2183 MACDADE BLVD, HOLMES, PA 19043 (Tel: 6104616371)

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Updated Business Mailing Address July 08, 2007

Registered at 2183 MACDADE BLVD, HOLMES, PA 19043 (Tel: 6104616371)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROGER RUNDBAKEN, D.M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #DS019696L in PA)

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Initial NPI Registration & Enumeration August 22, 2006

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: 1285740332
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 22, 2006
Last Update: July 08, 2007
Deactivation Date: January 13, 2017

Mailing Address

2183 Macdade Blvd

Holmes, PA 19043

Phone: 6104616371

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.