DR. MARK ALLEN ROETTGER DDS
NPI 1356325906
Dentist in Lake Elmo, MN

Q: What is Mark Roettger's NPI number?

The NPI number for Mark Roettger is 1356325906. It was assigned to this individual provider in the NPPES registry on December 6, 2005.

Q: What is Mark Roettger's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Mark Roettger was last updated on May 11, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 06, 2005PECOS Enrolled

12425 55TH STREET N, SUITE B, LAKE ELMO, MN 55042(651) 439-0322(651) 439-2201 Get Directions Write a Review

NPPES record last updated: May 11, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Mark Allen Roettger Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARK ALLEN ROETTGER DDS (NPI 1356325906) is an individual dentist in Lake Elmo, Minnesota, licensed in Minnesota (9426) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with M Health Fairview University Of Mn, and is a graduate of University Of Minnesota School Of Dentistry (1982).

NPPES Registry Identity

NPI1356325906

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. MARK ALLEN ROETTGERCredential: DDS

Location Address12425 55TH STREET N, SUITE BLake Elmo, MN 55042-4450

Mailing Address12425 55th Street N, Suite BLake Elmo, MN 55042-4450 · (651) 439-0322 · Fax (651) 439-2201

Phone(651) 439-0322

Fax(651) 439-2201

Sole ProprietorNo

Medical School CMSUniversity Of Minnesota School Of DentistryGraduated 1982

Enumeration DateDecember 6, 2005

Last NPPES UpdateMay 11, 2011

✔ NPI 1356325906 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MN · 9426

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

12425 55TH STREET N, Lake Elmo, MN 55042

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mark Allen Roettger Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1153506472

PECOS Enrollment IDI20260427001027

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

M Health Fairview University Of Mn

Acute Care Hospitals · Minneapolis, MN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240080

Location2450 Riverside AvenueMinneapolis, MN 55454 · Hennepin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55042 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Roettger's NPI number?

The NPI number for Mark Roettger is 1356325906. It was assigned to this individual provider in the NPPES registry on December 6, 2005.

Where is Mark Roettger located?

Mark Roettger practices at 12425 55th Street N Suite B, Lake Elmo, MN 55042. The listed phone number is (651) 439-0322.

What is Mark Roettger's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Mark Roettger enrolled in Medicare?

Yes. Mark Roettger is registered in the Medicare PECOS enrollment system.

What insurance does Mark Roettger accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Florida Combined Life and UnitedHealthcare list Mark Roettger as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mark Roettger affiliated with any hospitals?

According to CMS data, Mark Roettger is affiliated with M Health Fairview University Of Mn.

When was this NPI record last updated?

The NPPES record for Mark Roettger was last updated on May 11, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.