Individual provider Active NPI

William Russell Ross, D.D.S.

  • General Practice Dentistry
  • Waco, TX
National Provider Identifier
1881669653
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14121 Issued in TX
Practice address
3620 Scroggins Dr
Waco, TX 76705-2579
Phone
(254) 799-5746
Fax
(254) 799-4115
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14121 TX Primary

Addresses

Primary practice location

3620 Scroggins Dr
Waco, TX 76705-2579

Mailing address

3620 Scroggins Dr
Waco, TX 76705-2579
Phone (254) 799-5746

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
14121TXMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Health Associates of TX, P.C. General Practice PastSince Mar 7, 2021 Accepting new patients
Brazos Family Dentistry, L.L.P. General Practice Past Accepting new patients

Organizations & group practices 2

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1881669653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 SCROGGINS DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767052579",
            "telephone_number": "254-799-5746",
            "fax_number": "254-799-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 SCROGGINS DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767052579",
            "telephone_number": "254-799-5746",
            "fax_number": "254-799-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "WILLIAM",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "14121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; 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.