Tisha Ross, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN012802 Issued in GA

Practice address

2230 Towne Lake Pkwy
BLDG 1300 Ste 100
Woodstock, GA 30189

Phone

(678) 445-5444

Fax

(678) 445-5552

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Childrens Dentistry of Woodstock

  • Pediatric Dentistry
  • Woodstock, GA
  • NPI 1902965932
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1144252578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 TOWNE LAKE PKWY",
            "address_2": "BLDG 1300 STE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "30189",
            "telephone_number": "678-445-5444",
            "fax_number": "678-445-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 TOWNE LAKE PKWY",
            "address_2": "BLDG 1300 STE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "30189",
            "telephone_number": "678-445-5444",
            "fax_number": "678-445-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "TISHA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "012802",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN012802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer R Rose-Heflin, LPC
• Ashley Judith Rose, SLP
• Sara Roland Rose, PSY.D.
• Tyler Rose
• Christopher Thomas Ross, PT, DPT
• Riley Noelle Roth
• Inger K Roug, D.C,D.A.C.B.R.
• Emily Rowe, LCSW
• Jameson Roy
• Tameka Rozier, CADCII

• Pediatric Dentistry in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.