Joshua Clayton Rose, DDS
Individual provider Active NPI General Practice Dentistry · Bayboro, NC
NPI 1710072731 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1710072731
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 7479 (NC)
- Practice address
- 55 Ireland Rd
Bayboro, NC 28515 - Phone
- (252) 745-4560
- Fax
- (252) 745-4862
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160606002745 | NC | Order and Referring Only - Dentist |
4789974510 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7479 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rose and Rose DDS PA | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7479 | NC | Yes |
Addresses
Primary practice location
55 Ireland Rd
Bayboro, NC 28515
Mailing address
PO Box 489
Bayboro, NC 28515
Phone (252) 745-4560
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89902GG | Medicaid | NC |
Other providers in Bayboro, NC
- Teri Marla Friedman Reid
- Rha Health Services Inc
- Rha Health Services, Inc.
- Rose and Rose DDS PA
- Clarence Vernon Rose Jr.
- Rebecca Bolling Rose
- Sand and Sandals Outreach Ministries
- Sand and Sandals Outreach Ministries
- Dana Schelegle
- Francis Gerard Serio
All providers in Bayboro, NC · General Practice Dentistry in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.