Jaterra Dominique Ross, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2019021855 Issued in MO

Practice address

12300 Dorsett Rd
Maryland Heights, MO 63043-3906

Phone

(314) 254-4000

Fax

(314) 732-1826

NPI assigned

Jun 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ross Dental Studio PLLC

  • Dental Clinic/Center
  • Prosper, TX
  • NPI 1710621305
  NPD Authorized official
• The Smile Company Dental Care LLC

  • Dental Clinic/Center
  • Maryland Heights, MO
  • NPI 1518339258
  NPD (past)
• The Smile Company, Sleep Solutions, LLC

  • Durable Medical Equipment & Medical Supplies
  • Maryland Heights, MO
  • NPI 1386194827
  NPD (past)

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1053972646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7407 CEDAR DR",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620352710",
            "telephone_number": "847-404-7029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 DORSETT RD",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630433906",
            "telephone_number": "314-254-4000",
            "fax_number": "314-732-1826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JATERRA",
        "middle_name": "DOMINIQUE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2019021855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Ripplinger, M.S. CF-SLP
• Stephanie Rittgers, MSPT
• Galina Rivkin, M.D.
• Keith A. Robinson, D.M.D.
• Abigale Rosebaugh
• Remington Roy
• Royal Touch Adult Day Center LLC
• Karen E Ruecker, M.D.
• Mason Rushing, PHARMD
• Jerisha Lacrae Rutlin, LPC, NCC

• All providers in Maryland Heights, MO
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.