Paul J Rouse, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

179077 Issued in MS

Practice address

15024 Martin Luther King Jr Blvd
Gulfport, MS 39501

Phone

(228) 863-9781

Fax

(228) 864-8553

NPI assigned

Mar 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400716800000",
    "number": "1184693723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 MAGNOLIA DR N",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "395773236",
            "telephone_number": "601-928-5711",
            "fax_number": "601-928-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15024 MARTIN LUTHER KING JR BLVD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-863-9781",
            "fax_number": "228-864-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSE",
        "first_name": "PAUL",
        "middle_name": "J",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2014-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "179077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0060456",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; 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.