Kenton A Ross, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3174 Issued in AR

Practice address

106 N Locust Ave
Fayetteville, AR 72701-5114

Phone

(479) 973-9800

Fax

(479) 973-9246

NPI assigned

Mar 26, 2007

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 AR

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

Practice roles

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

• Kenton a Ross, DMD, PA

  • General Practice Dentistry
  • Fayetteville, AR
  • NPI 1356469506
  NPD (past) Authorized official

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265550404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 N LOCUST AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727015114",
            "telephone_number": "479-973-9800",
            "fax_number": "479-973-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 N LOCUST AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727015114",
            "telephone_number": "479-973-9800",
            "fax_number": "479-973-9246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KENTON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Howard Ross
• Audrey Kay Ross
• Joseph Guard Ross, MD
• Justin Stanley Ross
• Katherine Grace Ross, PA
• Mitchell David Ross, MD
• Thomas Trigg Ross, PT
• William Landon Ross, PA-C
• Kristin Rossi, M.A., CCC-SLP
• Lauren Rosso, PSY.D.

• General Practice Dentistry in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.