NPIMap

Organization Active NPI

Ross Roupas Burd & Sullivan DDS PLLC

  • Dentist
  • Monroe, NC
National Provider Identifier
1063797462
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6304 Issued in NC
Legal business name
ROSS ROUPAS BURD & SULLIVAN DDS PLLC
Practice address
901 Oak Forest Dr
Monroe, NC 28112-5146
Phone
(704) 568-8010
NPI assigned
Oct 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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

Authorized official

Name
Dr. Anastasi J. Roupas, DMD
Title
Partner / Organizer
Phone
(704) 568-8010

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 6304 NC Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 8215 NC
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 5545 NC
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 4121 NC

Addresses

Primary practice location

901 Oak Forest Dr
Monroe, NC 28112-5146

Mailing address

5833 Phyliss LN
Mint Hill, NC 28227-9031
Phone (704) 568-8010

Other names 1

  • Monroe Family Dental Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318809600000",
    "number": "1063797462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5833 PHYLISS LN",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282279031",
            "telephone_number": "704-568-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 OAK FOREST DR",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281125146",
            "telephone_number": "704-568-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSS ROUPAS BURD & SULLIVAN DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-17",
        "last_updated": "2011-10-17",
        "status": "A",
        "authorized_official_last_name": "ROUPAS",
        "authorized_official_first_name": "ANASTASI",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PARTNER / ORGANIZER",
        "authorized_official_telephone_number": "704-568-8010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "6304",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "8215",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5545",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "4121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monroe Family Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroe, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.