Active NPI
S Burton Ross, DDS
- Dentist
- Tucson, AZ
National Provider Identifier
1013117290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2164
- Practice address
- 2122 N Craycroft Rd
#106
Tucson, AZ 85712-2849 - Phone
- (520) 886-3100
- Fax
- (520) 886-4647
- NPI assigned
- Jul 25, 2007
- 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 | 2164 | AZ | Primary |
Addresses
Primary practice location
2122 N Craycroft Rd
#106
Tucson, AZ 85712-2849
Mailing address
2122 N Craycroft Rd
#106
Tucson, AZ 85712-2849
Phone (520) 886-3100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2164 | AZ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185321600000",
"number": "1013117290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2122 N CRAYCROFT RD",
"address_2": "#106",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857122849",
"telephone_number": "520-886-3100",
"fax_number": "520-886-4647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2122 N CRAYCROFT RD",
"address_2": "#106",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857122849",
"telephone_number": "520-886-3100",
"fax_number": "520-886-4647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "S",
"middle_name": "BURTON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-25",
"last_updated": "2007-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "2164",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.