Individual provider Active NPI

Alexander Rossitch, DDS

  • General Practice Dentistry
  • Charlotte, NC
National Provider Identifier
1073739991
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5569 Issued in NC
Practice address
1901 Brunswick Ave
Suite 250
Charlotte, NC 28207-2809
Phone
(704) 372-0290
Fax
(704) 372-7786
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5569 NC Primary

Addresses

Primary practice location

1901 Brunswick Ave
Suite 250
Charlotte, NC 28207-2809

Mailing address

1901 Brunswick Ave
Suite 250
Charlotte, NC 28207-2809
Phone (704) 372-0290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20170411000850 NC Order and Referring Only - DentistPractitioner - Dentist 3870879612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073739991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 BRUNSWICK AVE",
            "address_2": "SUITE 250",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072809",
            "telephone_number": "704-372-0290",
            "fax_number": "704-372-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 BRUNSWICK AVE",
            "address_2": "SUITE 250",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072809",
            "telephone_number": "704-372-0290",
            "fax_number": "704-372-7786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSITCH",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.