Enoch Nathan Ross, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1189 Issued in AK

Practice address

12641 Old Glenn Hwy
Suite 104
Eagle River, AK 99577-7039

Phone

(907) 622-7874

Fax

(907) 622-7876

NPI assigned

Mar 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1245356245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 112452",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995112452",
            "telephone_number": "909-528-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12641 OLD GLENN HWY",
            "address_2": "SUITE 104",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777039",
            "telephone_number": "907-622-7874",
            "fax_number": "907-622-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "ENOCH",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "1189",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "8665",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00011127",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Rogers, BA
• Elizabeth Rogers, LCSW
• Jolene Denee Rogers, MA, LPC
• Enoch Ronduen, PHARMD
• Christopher Greg Rosenvall, D.D.S.
• Leslie A Rost, M.S. CCC-SLP
• Kes-Sativa Meketta Cheyanne Roy
• Dylan Michael Rubinic, PT, DPT, ATC
• Janet M Runyan, M.S., LPC
• Catherine Karas Rutherford, PH.D.

• Dentist in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Dentist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; 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.