Active NPI
Ross Emerick, DDS
- Dentist
- Fort Stewart, GA
National Provider Identifier
1073099826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D10836
- Practice address
- 351 West 6TH Street
Fort Stewart, GA 31314 - Phone
- (912) 435-6777
- NPI assigned
- Jul 16, 2018
- 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 | D10836 | OR | Primary |
Addresses
Primary practice location
351 West 6TH Street
Fort Stewart, GA 31314
Mailing address
351 West 6TH Street
Fort Stewart, GA 31314
Other practice location 1
9900 Lincoln Street, 2nd Floor, ATTN:Credentials Office
US Army DENTAC
Tacoma, WA 98327
Phone (253) 968-4079
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 |
|---|---|---|---|
| D10836 | OR | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567036800000",
"number": "1073099826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "351 WEST 6TH STREET",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "31314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "351 WEST 6TH STREET",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "31314",
"telephone_number": "912-435-6777"
}
],
"practiceLocations": [
{
"address_1": "9900 Lincoln Street, 2nd Floor, ATTN:Credentials Office",
"address_2": "US Army DENTAC",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "98327",
"country_code": "US",
"telephone_number": "253-968-4079",
"fax_number": "253-968-5919",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EMERICK",
"first_name": "ROSS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-16",
"last_updated": "2019-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D10836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Stewart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.