Individual provider Active NPI

Chad Alan Ross

  • Pediatric Dentistry
  • Erie, CO
National Provider Identifier
1770102576
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DEN.00205855 Issued in CO
Practice address
61 Erie Pkwy
Erie, CO 80516-2591
Phone
(303) 500-3202
NPI assigned
Apr 11, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X DEN.00205855 CO Primary

Addresses

Primary practice location

61 Erie Pkwy
Erie, CO 80516-2591

Mailing address

2308 Ranch Dr
Westminster, CO 80234-2667
Phone (727) 631-1225

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
DEN.00205855COMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Bresler Richmond Dental Associates Single Specialty PastSince May 1, 2022 Accepting new patients
Mini Miners Pediatric Dentistry Pediatric Dentistry PastSince Feb 19, 2023 Accepting new patients
David a. Bresler DDS PC Pediatric Dentistry PastSince May 1, 2022 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1586563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1770102576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 RANCH DR",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342667",
            "telephone_number": "727-631-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 ERIE PKWY",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805162591",
            "telephone_number": "303-500-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "CHAD",
        "middle_name": "ALAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-11",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "DEN.00205855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.