Robert Louis Rose, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

4539 Issued in WA

Practice address

15 SW 20TH Avenue
Battle Ground, WA 98604

Phone

(360) 687-5665

Fax

(360) 687-5053

NPI assigned

Apr 26, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053531582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157",
            "address_2": "15 SW 20TH AVENUE",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986040157",
            "telephone_number": "360-687-5665",
            "fax_number": "360-687-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SW 20TH AVENUE",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "98604",
            "telephone_number": "360-687-5665",
            "fax_number": "360-687-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ROBERT",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "4539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE NPI",
            "identifier": "1043317449",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vickie Lee Roler, LMHC
• Rose Family Dental
• Rose Medical Groups, PC
• Karl David Rose, D.D.S
• Rikki Marie Rose, LMT
• Brenda Leigh Roulet, LICSW
• Jasmine C Rudman, RN
• Laura Ruotsalainen, RN
• Vasile Rus
• Tasha Marie Russell, LMP

• Dentist in Battle Ground, WA
• Providers in Battle Ground, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.