Active NPI
Tommy Rose, DDS
- Dentist
- Kansas City, KS
National Provider Identifier
1003806191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6742
- Practice address
- 753 State Ave
Ste 402
Kansas City, KS 66101-2516 - Phone
- (913) 321-3999
- Fax
- (913) 321-5766
- NPI assigned
- Oct 28, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6742 | KS | Primary |
Addresses
Primary practice location
753 State Ave
Ste 402
Kansas City, KS 66101-2516
Mailing address
753 State Ave
Ste 402
Kansas City, KS 66101-2516
Phone (913) 321-3999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160725002301 | KS | Order and Referring Only - Dentist | 1052604386 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6742 | KS | MD | Social Worker |
Networks
- devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
- devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
- devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1003806191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "753 STATE AVE",
"address_2": "STE 402",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661012516",
"telephone_number": "913-321-3999",
"fax_number": "913-321-5766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "753 STATE AVE",
"address_2": "STE 402",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661012516",
"telephone_number": "913-321-3999",
"fax_number": "913-321-5766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "TOMMY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-28",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KS",
"license": "6742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.