Individual provider Active NPI

Frank A. Ross Jr., DDS

  • General Practice Dentistry
  • Stratford, CT
National Provider Identifier
1346359544
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4888 Issued in CT
Practice address
1761 W Broad St
Stratford, CT 06615-5752
Phone
(203) 375-3763
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 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 4888 CT Primary

Addresses

Primary practice location

1761 W Broad St
Stratford, CT 06615-5752

Mailing address

1761 W Broad St
Stratford, CT 06615-5752
Phone (203) 375-3763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20150610002169 CT Order and Referring Only - DentistPractitioner - Dentist 7719208180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431993600000",
    "number": "1346359544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 W BROAD ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066155752",
            "telephone_number": "203-375-3763",
            "fax_number": "203-375-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 W BROAD ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066155752",
            "telephone_number": "203-375-3763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "FRANK",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "4888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, CT

Sources for this page

Verify at the official NPI Registry.