Active NPI
Gregory K. Ross, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Forest Lake, MN
National Provider Identifier
1477607075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 10565
- Practice address
- 1068 Lake St S
Suite 205
Forest Lake, MN 55025-2639 - Phone
- (651) 464-6988
- NPI assigned
- Jan 22, 2007
- Last updated
- Jul 1, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 10565 | MN | Primary |
Addresses
Primary practice location
1068 Lake St S
Suite 205
Forest Lake, MN 55025-2639
Mailing address
1068 Lake St S
Suite 205
Forest Lake, MN 55025-2639
Phone (651) 464-6988
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10565 | MN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rossodontics Dental Sleep Medicine | Orthodontics and Dentofacial Orthopedics | Current | Accepting new patients |
| Rossodontics Dental Sleep Medicine | Current | Accepting new patients |
Locations
1068 Lake St S
Ste 205
Forest Lake, MN 55025
Phone (651) 464-6988
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Forest Lake, MN
- NPI 1588094171
-
- Dentist
- Hudson, WI
- NPI 1912457003
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435708800000",
"number": "1477607075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1068 LAKE ST S",
"address_2": "SUITE 205",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "550252639",
"telephone_number": "651-464-6988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1068 LAKE ST S",
"address_2": "SUITE 205",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "550252639",
"telephone_number": "651-464-6988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "GREGORY",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2015-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MN",
"license": "10565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.