Individual provider Active NPI

Jessica Rose, DDS, MSD

  • Pediatric Dentistry
  • Huntersville, NC
National Provider Identifier
1699345694
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
14005 Issued in NC
Practice address
15810 Northcross Dr Ste a
Huntersville, NC 28078-5070
Phone
(704) 909-4566
NPI assigned
Jun 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 14005 NC Primary
Dentist 122300000X 0401417538 VA

Addresses

Primary practice location

15810 Northcross Dr Ste a
Huntersville, NC 28078-5070

Mailing address

15810 Northcross Dr Ste a
Huntersville, NC 28078-5070
Phone (704) 909-4566

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

LicenseStateTypeSpecialty
0401417538VAMDDentist
14005NCMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
John M. Bakarich, DDS, PLLC Pediatric Dentistry CurrentSince Jan 19, 2025 Accepting new patients

Locations

15810 Northcross Dr
Ste A
Huntersville, NC 28078
Phone (704) 909-4566

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": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1699345694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15810 NORTHCROSS DR STE A",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785070",
            "telephone_number": "704-909-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15810 NORTHCROSS DR STE A",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785070",
            "telephone_number": "704-909-4566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "JESSICA",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "14005",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401417538",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; 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.