NPIMap

Organization Active NPI

Dr Tracey Butler Ross, DMD, PLLC

  • General Practice Dentistry
  • Covington, KY
National Provider Identifier
1407901457
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6627 Issued in KY
Legal business name
DR TRACEY BUTLER ROSS, DMD, PLLC
Practice address
1044 Scott St
Covington, KY 41011-3159
Phone
(859) 291-1818
Fax
(859) 291-6441
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Authorized official

Name
Dr. Tracey Butler Ross, DMDNPI 1053407965
Title
Owner
Phone
(859) 291-1818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 6627 KY Primary

Addresses

Primary practice location

1044 Scott St
Covington, KY 41011-3159

Mailing address

1044 Scott St
Covington, KY 41011-3159
Phone (859) 291-1818

Other identifiers 3

IdentifierTypeStateIssuer
2446642MedicaidOH
45002664MedicaidKY
60001856MedicaidKY

Other names 1

  • DR TRACEY BUTLER ROSS, DMD, PLLC Doing business as

National Provider Directory

National Provider Directory

Locations

1044 Scott St
Covington, KY 41011
Phone (859) 291-1818

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1407901457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 SCOTT ST",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410113159",
            "telephone_number": "859-291-1818",
            "fax_number": "859-291-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 SCOTT ST",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410113159",
            "telephone_number": "859-291-1818",
            "fax_number": "859-291-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR TRACEY BUTLER ROSS, DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "BUTLER ROSS",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-291-1818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "6627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2446642",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45002664",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60001856",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DR TRACEY BUTLER ROSS, DMD, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Covington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; 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.