Jonathan Caleb Rossall, D.D.S.,M.M.SC.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

22596 Issued in TX

Practice address

4005 Brookside Dr
Tyler, TX 75701-9425

Phone

(903) 939-3636

Fax

(930) 939-1687

NPI assigned

Feb 27, 2007

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

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tyler Endodontics, PLLC

  • Endodontics
  • Tyler, TX
  • NPI 1871620930
  NPD Authorized official

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1699802744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 BROOKSIDE DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019425",
            "telephone_number": "903-939-3636",
            "fax_number": "930-939-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 BROOKSIDE DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019425",
            "telephone_number": "903-939-3636",
            "fax_number": "930-939-1687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSALL",
        "first_name": "JONATHAN",
        "middle_name": "CALEB",
        "name_prefix": "Dr.",
        "credential": "D.D.S.,M.M.SC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "22596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Ross
• Cheyenne Ross
• Jamesha Ross
• Jessica Ross, A-SLP
• Rachel Lauren Ross, DPM
• Jordan Rosson
• Richard O Rothwell, M.D.
• Jack Rounds Jr., MD
• Craig Rountree
• Paul Pollard Rountree, MD

• Endodontics in Tyler, TX
• Providers in Tyler, TX by specialty
• Endodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.