Charles Calvert Rosson III, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D6305 Issued in OR

Practice address

5025 SE 28TH Ave
Portland, OR 97202-4445

Phone

(503) 238-4418

NPI assigned

Jul 13, 2006

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

Not listed in the public Medicare enrollment file

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.

• Kaiser Dental

  • Dental Assistant
  • Portland, OR
  • NPI 1003965922
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1467477315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST",
            "address_2": "STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322031",
            "telephone_number": "503-813-4947",
            "fax_number": "503-813-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5025 SE 28TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972024445",
            "telephone_number": "503-238-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSON",
        "first_name": "CHARLES",
        "middle_name": "CALVERT",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Rossi, RN
• Jack William Rossing, M. ED. (COUNSELING)
• Malini Rossington, CRNA
• Angela M Rosson, L.P.C.
• Camille Elise Rosson, MD
• Constance Rosson, MD
• Nicholas Rosson
• Mojgan Rostamian, D.M.D.
• Theresa Rostampour
• Kiel Rotarius, BCBA, LBA

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; 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.