Derek Brandon Roos, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

2901021676 Issued in MI

Practice address

2041 15 Mile Rd
Sterling Heights, MI 48310-4801

Phone

(586) 268-0900

NPI assigned

Aug 20, 2015

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

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440028800000",
    "number": "1679949952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 HAZELWOOD ST",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480093824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 15 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104801",
            "telephone_number": "586-268-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOS",
        "first_name": "DEREK",
        "middle_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.

Verify at the official NPI Registry.