Eric Bruce Rosengren, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60269425 Issued in WA

Practice address

24722 104TH Ave SE
Suite 201
Kent, WA 98030-5322

Phone

(253) 859-0123

Fax

(253) 859-5864

NPI assigned

Jun 18, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Rosengren Family Dental Group, Inc.

  dba Rosengren Family Dental Group

  • General Practice Dentistry
  • Kent, WA
  • NPI 1669732897
  NPD (past) Authorized official
• Gordon B Rosengren, DDS, Inc, PS

  • Dental Clinic/Center
  • Kent, WA
  • NPI 1730282054
  NPD (past)

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337644800000",
    "number": "1508093386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24722 104TH AVE SE",
            "address_2": "SUITE 201",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980305322",
            "telephone_number": "253-859-0123",
            "fax_number": "253-859-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24722 104TH AVE SE",
            "address_2": "SUITE 201",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980305322",
            "telephone_number": "253-859-0123",
            "fax_number": "253-859-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENGREN",
        "first_name": "ERIC",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-18",
        "last_updated": "2012-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60269425",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "60758",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200632500A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alisha Elizabeth Romney, D.C.
• Renee Romo, MA, LAT, ATC
• Hannah Grace Rosborough, CDP
• Brighid O Rose, DPT
• Rosengren Family Dental Group, Inc. (Rosengren Family Dental Group)
• Philip Rosengren, DDS
• Stephanie Rosentrater, SLP
• Margarita Rossiytseva
• Robert B. Rourke, D.D.S.
• Dorothy Routt, RN

• General Practice Dentistry in Kent, WA
• Providers in Kent, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; 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.