Active NPI
Timothy Wayne Rose, D.M.D.
- General Practice Dentistry
- Frankfort, KY
National Provider Identifier
1164501532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6782
- Practice address
- 690 Teton TRL
Frankfort, KY 40601-1766 - Phone
- (502) 223-2300
- NPI assigned
- Nov 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6782 | KY | Primary |
| General Practice Dentistry | 1223G0001X | DN14484 | FL |
Addresses
Primary practice location
690 Teton TRL
Frankfort, KY 40601-1766
Mailing address
101 Peaks Mill Rd
Frankfort, KY 40601-9435
Phone (502) 875-4867
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN14484 | FL | MD | General Practice Dentistry |
| 6782 | KY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164501532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 PEAKS MILL RD",
"city": "FRANKFORT",
"state": "KY",
"postal_code": "406019435",
"telephone_number": "502-875-4867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "690 TETON TRL",
"city": "FRANKFORT",
"state": "KY",
"postal_code": "406011766",
"telephone_number": "502-223-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "TIMOTHY",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "6782",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN14484",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Frankfort, KY
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.