Individual provider Active NPI

Donald J Rossetti, DMD

  • General Practice Dentistry
  • New Albany, MS
National Provider Identifier
1235344631
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
199182 Issued in MS
Practice address
110 N Camp Ave
New Albany, MS 38652
Phone
(662) 534-5826
Fax
(662) 534-7218
NPI assigned
May 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 199182 MS Primary

Addresses

Primary practice location

110 N Camp Ave
New Albany, MS 38652

Mailing address

110 N Camp Ave
PO Box 1938
New Albany, MS 38652
Phone (662) 534-5826

Other identifiers 1

IdentifierTypeStateIssuer
00064973MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20160405000044 MS Order and Referring Only - DentistPractitioner - Dentist 1658678792

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
199182MSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Rossetti Dental Association, P.a. General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1235344631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N CAMP AVE",
            "address_2": "PO BOX 1938",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "38652",
            "telephone_number": "662-534-5826",
            "fax_number": "662-534-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N CAMP AVE",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "38652",
            "telephone_number": "662-534-5826",
            "fax_number": "662-534-7218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSETTI",
        "first_name": "DONALD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "199182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00064973",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, MS

Sources for this page

Verify at the official NPI Registry.