Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Micah A Roberts, DMD

Individual provider Dentist · NPI 1760746747

Dr. Micah A Roberts, DMD is a Dentist in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2012.

Licensed in
IL
In the registry since
2012
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

4517 N Rockwood Dr
Peoria, IL 61615-3841
Phone: (309) 693-0043
Fax: (309) 688-5643
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 019029023 (IL)
Dentist Taxonomy 122300000X · Licence 019.029023 (IL)

Record details

NPI number1760746747
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedJune 25, 2012
Last updated in NPPESOctober 6, 2020
Certification dateOctober 6, 2020
Mailing address4517 N Rockwood Dr, Peoria, IL 61615-3841

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