NPIMap

Organization Active NPI

Ross Family Dental

  • Dentist
  • Albuquerque, NM
National Provider Identifier
1134427487
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD2625 Issued in NM
Legal business name
ROSS FAMILY DENTAL
Practice address
10330 Montgomery Blvd NE
Suite a
Albuquerque, NM 87111-3600
Phone
(505) 293-7441
NPI assigned
Mar 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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

Authorized official

Name
Dr. Kerry Ross, DDSNPI 1104923085
Title
Owner
Phone
(505) 293-7441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DD2625 NM Primary

Addresses

Primary practice location

10330 Montgomery Blvd NE
Suite a
Albuquerque, NM 87111-3600

Mailing address

10330 Montgomery Blvd NE
Suite a
Albuquerque, NM 87111-3600
Phone (505) 293-7441

Other identifiers 2

IdentifierTypeStateIssuer
1104923085OtherNMINDIVIDUAL NPI
1124125091OtherNMINDIVIDUAL NPI

National Provider Directory

National Provider Directory

Locations

10330 Montgomery Blvd NE
Ste A
Albuquerque, NM 87111
Phone (505) 293-7441

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1299715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299715200000",
    "number": "1134427487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 MONTGOMERY BLVD NE",
            "address_2": "SUITE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113600",
            "telephone_number": "505-293-7441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10330 MONTGOMERY BLVD NE",
            "address_2": "SUITE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113600",
            "telephone_number": "505-293-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSS FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-10",
        "last_updated": "2011-03-10",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-293-7441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD2625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1104923085",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1124125091",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.