Individual provider Active NPI

Justin Taylor Ross, DMD

  • General Practice Dentistry
  • Temple, TX
National Provider Identifier
1710473681
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34898 Issued in TX
Practice address
1605 Forest TRL
Temple, TX 76502-2715
Phone
(903) 746-0384
NPI assigned
Jul 3, 2018
Last updated
Sep 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN23519 FL
General Practice Dentistry 1223G0001X 34898 TX Primary

Addresses

Primary practice location

1605 Forest TRL
Temple, TX 76502-2715

Mailing address

1605 Forest TRL
Temple, TX 76502-2715
Phone (903) 746-0384

Other practice location 1

409 W Ferguson St
Tyler, TX 75702-5632
Phone (903) 596-8353

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
DN23519FLMDGeneral Practice Dentistry
34898TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Justin T. Ross, DMD, PLLC General Practice CurrentSince Sep 20, 2022 Accepting new patients

Locations

1605 Forest Trl
Temple, TX 76502
Phone (254) 778-3751

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": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1710473681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 FOREST TRL",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765022715",
            "telephone_number": "903-746-0384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 FOREST TRL",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765022715",
            "telephone_number": "903-746-0384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "409 W Ferguson St",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757025632",
            "country_code": "US",
            "telephone_number": "903-596-8353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JUSTIN",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23519",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.