Herschel Ross, HERSCHEL ROSS DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4389 Issued in CO

Practice address

234 Midland Ave
Basalt, CO 81621-8162

Phone

(970) 927-9112

Fax

(970) 927-5342

NPI assigned

Jun 30, 2008

Last updated

Jun 30, 2008By the provider in NPPES

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

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": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1184886160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1999",
            "city": "BASALT",
            "state": "CO",
            "postal_code": "816211999",
            "telephone_number": "970-927-9112",
            "fax_number": "970-927-5342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 MIDLAND AVE",
            "city": "BASALT",
            "state": "CO",
            "postal_code": "816218162",
            "telephone_number": "970-927-9112",
            "fax_number": "970-927-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "HERSCHEL",
        "name_prefix": "Dr.",
        "credential": "HERSCHEL ROSS DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "4389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Basalt, CO
• Providers in Basalt, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.