Individual provider Active NPI

William Gregory Rose, DDS

  • General Practice Dentistry
  • Albuquerque, NM
National Provider Identifier
1932278447
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD1897 Issued in NM
Practice address
4550 Eubank Blvd NE
Suite 201
Albuquerque, NM 87111-3479
Phone
(505) 296-5544
Fax
(505) 296-6918
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DD1897 NM Primary

Addresses

Primary practice location

4550 Eubank Blvd NE
Suite 201
Albuquerque, NM 87111-3479

Mailing address

4550 Eubank Blvd NE
Suite 201
Albuquerque, NM 87111-3479
Phone (505) 296-5544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20160420000595 NM Order and Referring Only - DentistPractitioner - Dentist 0244414324

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
W Gregory Rose DDS PA PastSince Mar 23, 2011 Accepting new patients

Organizations & group practices 1

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932278447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 EUBANK BLVD NE",
            "address_2": "SUITE 201",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113479",
            "telephone_number": "505-296-5544",
            "fax_number": "505-296-6918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 EUBANK BLVD NE",
            "address_2": "SUITE 201",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113479",
            "telephone_number": "505-296-5544",
            "fax_number": "505-296-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "WILLIAM",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD1897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.