Grant Ross, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D.0006775-C1 Issued in AL

Practice address

1100 Rucker Blvd Ste A1
Enterprise, AL 36330-3623

Phone

(334) 347-5550

Fax

(334) 347-5551

NPI assigned

Feb 26, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

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.

• Advantage Dental Oral Health and Vision Center of Alabama, P.C.

  • General Practice Dentistry
  • Enterprise, AL
  • NPI 1114186699
  NPD (past)

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1770040735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "478 MAYBERRY WAY",
            "city": "NEW BROCKTON",
            "state": "AL",
            "postal_code": "363515527",
            "telephone_number": "601-503-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 RUCKER BLVD STE A1",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363303623",
            "telephone_number": "334-347-5550",
            "fax_number": "334-347-5551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Westchester Hall",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117940001",
            "country_code": "US",
            "telephone_number": "631-444-2557",
            "fax_number": "631-444-6013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "GRANT",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-26",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24882",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "D.0006775-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Roland
• Richard Allen Roller, MD, PHD
• Olivia Rorie
• Laura Rosa
• Natasha Lynn Rosekrans
• Janna C Routh, DMD
• Hannah Joy Roy, LMT
• Danielle Victoria Russell, RD
• Joseph Paul Russell, RPH
• S. Jill Spurlin, DMD, LLC

• Dentist in Enterprise, AL
• Providers in Enterprise, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.