Rosen Georgiev Dimov, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DE.60294925 Issued in WA

Practice address

6607 W Canal Dr
Kennewick, WA 99336-5077

Phone

(862) 452-0961

NPI assigned

Jul 27, 2012

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 WA

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

State licenses

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345075200000",
    "number": "1205182193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6305 143RD PL SE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982965252",
            "telephone_number": "862-452-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6607 W CANAL DR",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993365077",
            "telephone_number": "862-452-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMOV",
        "first_name": "ROSEN",
        "middle_name": "GEORGIEV",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-27",
        "last_updated": "2012-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE.60294925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Eileen Didier
• Denise Janell Dietz, ED.D., MFT, NCC
• Maria Yesenia Diez Canseco
• Clint Randall Dillard
• Randy Dimond, LPN
• Colleen Dionne-Newell, MSW
• Judith Kay Dirks, M. A.
• Discreet Supplies LLC
• Kathryn Jo Dissing, R.N.
• Jennie Kay Dixon

• Dentist in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; 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.