Individual provider Active NPI

Adrian Rose, DDS

  • Dentist
  • Boca Raton, FL
National Provider Identifier
1497734438
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9959 Issued in FL
Practice address
6156 NW 31St CT
Boca Raton, FL 33496-3318
Phone
(561) 542-1400
NPI assigned
Jan 10, 2006
Last updated
Apr 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9959 FL Primary

Addresses

Primary practice location

6156 NW 31St CT
Boca Raton, FL 33496-3318

Mailing address

6156 NW 31St CT
Boca Raton, FL 33496-3318
Phone (561) 542-1400

Other identifiers 1

IdentifierTypeStateIssuer
9959OtherFLSTATE OF FLORIDA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160302002185 FL Order and Referring Only - DentistPractitioner - Dentist 5294031126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9959FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Dental Health PastSince Apr 19, 2016 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1497734438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6156 NW 31ST CT",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334963318",
            "telephone_number": "561-542-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6156 NW 31ST CT",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334963318",
            "telephone_number": "561-542-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ADRIAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "9959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA",
            "identifier": "9959",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.