Individual provider Active NPI

Andrew S Ross, DMD

  • General Practice Dentistry
  • Oxford, MS
National Provider Identifier
1114153723
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
349309 Issued in MS
Practice address
2710 W Oxford Loop
Oxford, MS 38655-5726
Phone
(662) 237-2722
Fax
(662) 234-2727
NPI assigned
Jun 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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 349309 MS Primary

Addresses

Primary practice location

2710 W Oxford Loop
Oxford, MS 38655-5726

Mailing address

2710 W Oxford Loop
Oxford, MS 38655-5726
Phone (662) 237-2722

Other identifiers 1

IdentifierTypeStateIssuer
07520777MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20160802001608 MS Order and Referring Only - DentistPractitioner - Dentist 6800180621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
349309MSMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1114153723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 W OXFORD LOOP",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555726",
            "telephone_number": "662-237-2722",
            "fax_number": "662-234-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 W OXFORD LOOP",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555726",
            "telephone_number": "662-237-2722",
            "fax_number": "662-234-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "ANDREW",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-09",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "349309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07520777",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.