Individual provider Active NPI

Karl A. Rose, DDS

  • Periodontics
  • Chevy Chase, MD
National Provider Identifier
1093830846
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
D54127 Issued in MD
Practice address
5454 Wisconsin Ave
Suite 620
Chevy Chase, MD 20815-6901
Phone
(301) 652-3355
Fax
(301) 652-5609
NPI assigned
Mar 20, 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
Periodontics 1223P0300X D54127 MD Primary

Addresses

Primary practice location

5454 Wisconsin Ave
Suite 620
Chevy Chase, MD 20815-6901

Mailing address

9427 Fox Hollow Dr
Potomac, MD 20854-2082
Phone (301) 983-2562

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

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093830846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9427 FOX HOLLOW DR",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208542082",
            "telephone_number": "301-983-2562",
            "fax_number": "301-652-5609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5454 WISCONSIN AVE",
            "address_2": "SUITE 620",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208156901",
            "telephone_number": "301-652-3355",
            "fax_number": "301-652-5609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KARL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MD",
            "license": "D54127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.