Kelly S Rose, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

050914 Issued in NY

Practice address

1100 Main St
Buffalo, NY 14209-2308

Phone

(716) 242-8200

NPI assigned

May 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

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.

• Pediatric Dental Associates PLLC

  • Pediatric Dentistry
  • Williamsville, NY
  • NPI 1144730649
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1932167145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092308",
            "telephone_number": "716-242-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092308",
            "telephone_number": "716-242-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KELLY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "050914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03376083",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony F Rosati, PHARM.D.
• Sonam Tshering Rosberger, M.D.
• Imani Roscoe
• Alexis Rose
• Chanell M Rose, LPN
• Rebecca D Rose
• Anne Kathleen Roseberry, LCSW
• Barbara L Rosen, OTR
• Lawrence A Rosen, DDS
• Sarah Rosen, LCSW

• Pediatric Dentistry in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.