Active NPI
John B. Rose III, D.D.S.
- Prosthodontics
- Fredericksburg, VA
National Provider Identifier
1194720029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 4929
- Practice address
- 414 Chatham Square Office Park
Fredericksburg, VA 22405-2561 - Phone
- (540) 371-0030
- NPI assigned
- Jun 16, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 4929 | VA | Primary |
Addresses
Primary practice location
414 Chatham Square Office Park
Fredericksburg, VA 22405-2561
Mailing address
414 Chatham Square Office Park
Fredericksburg, VA 22405-2561
Phone (540) 371-0030
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 |
|---|---|---|---|
| 4929 | VA | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189641600000",
"number": "1194720029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 CHATHAM SQUARE OFFICE PARK",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224052561",
"telephone_number": "540-371-0030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 CHATHAM SQUARE OFFICE PARK",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224052561",
"telephone_number": "540-371-0030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "JOHN",
"middle_name": "B.",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2007-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "VA",
"license": "4929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.