Individual provider Active NPI

Steve Paul Rose, D.D.M.

  • Dentist
  • Ft Myer, VA
National Provider Identifier
1427238799
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN - 9467 Issued in CO
Practice address
401 Carpenter Rd
Ft Myer, VA 22211-1009
Phone
(703) 696-3460
Fax
(703) 696-0586
NPI assigned
Nov 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN - 9467 CO Primary

Addresses

Primary practice location

401 Carpenter Rd
Ft Myer, VA 22211-1009

Mailing address

6900 Georgia Ave NW
Washington, DC 20307-0003
Phone (703) 696-3460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20160603001268 CO Order and Referring Only - DentistPractitioner - Dentist 0840580874

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN - 9467COMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1427238799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 GEORGIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "203070003",
            "telephone_number": "703-696-3460",
            "fax_number": "703-696-0586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CARPENTER RD",
            "city": "FT MYER",
            "state": "VA",
            "postal_code": "222111009",
            "telephone_number": "703-696-3460",
            "fax_number": "703-696-0586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "STEVE",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-05",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN - 9467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Myer, VA

Sources for this page

Verify at the official NPI Registry.