Ross Jared Reddock, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14883 Issued in NC

Practice address

Marine Centered Medical Home Wallace Creek, BLDG. WC 2
Birch St
Camp Lejeune, NC 28542

Phone

(910) 451-6122

NPI assigned

Jun 24, 2026

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1782259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1790601946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 FOUNTAIN LN",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117532317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARINE CENTERED MEDICAL HOME WALLACE CREEK, BLDG. WC 2",
            "address_2": "BIRCH ST",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "28542",
            "telephone_number": "910-451-6122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDOCK",
        "first_name": "ROSS",
        "middle_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-24",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "14883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Marie Raymer, PA-C
• Jenna Reaves, PHARMD
• Nicholas Jordan Reaves, M.D.
• Terrance Tyler Receveur, DDS
• Anthony Micheal Reddick
• Ashley N Reece, DDS
• Jennifer Reed, MSPT
• Kenneth Reeder, PH.D.
• Janice Michelle Rees, NP
• Lindsay Reinhardt, PH.D.

• General Practice Dentistry in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.