Adam David Ross, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1002107-15 Issued in WI

Practice address

8796 Brunswick Rd
Minocqua, WI 54548-9346

Phone

(715) 356-2060

NPI assigned

Jun 17, 2019

Last updated

Jun 17, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1154981744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8796 BRUNSWICK RD",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545489346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8796 BRUNSWICK RD",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545489346",
            "telephone_number": "715-356-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "ADAM",
        "middle_name": "DAVID",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1002107-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila S Reichel, PAC
• Kathleen Yvonne-Thomas Reimer, RN
• Theresa Riebe
• Leonna Christine Robertson, REGISTERED NURSE
• Anna M Rosen, APNP
• Doris L Ruder, APNP
• Debra Joan Sanfilippo, PA
• Michael J Schaars, MD
• Suzanne L Scheldroup, LCSW
• Sara Walker Scholten, PAC

• General Practice Dentistry in Minocqua, WI
• Providers in Minocqua, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.