Healthcare Provider Details

I. General information

NPI: 1760318943
Provider Name (Legal Business Name): JOSHUA ROH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 N 44TH ST
LINCOLN NE
68503-3701
US

IV. Provider business mailing address

1353 N 40TH ST
LINCOLN NE
68503-2109
US

V. Phone/Fax

Practice location:
  • Phone: 402-227-8744
  • Fax:
Mailing address:
  • Phone: 402-367-9222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8227
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: