Healthcare Provider Details

I. General information

NPI: 1811644198
Provider Name (Legal Business Name): TAMAR ROGOSZINSKI DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2022
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12022 SW 88TH ST
MIAMI FL
33186-2002
US

IV. Provider business mailing address

4422 3RD AVE
BRONX NY
10457-2545
US

V. Phone/Fax

Practice location:
  • Phone: 516-840-0190
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number063353-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number31490
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number22DI02947700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: