Ronald Andrew Rose, DDS
Individual provider Active NPI Dentist · Crum Lynne, PA
NPI 1972604049 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1972604049
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DS024198L (PA)
- Practice address
- 606 Chester Pike
Crum Lynne, PA 19022 - Phone
- (610) 833-5588
- Fax
- (610) 833-1760
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 5, 2016 through Apr 5, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS024198L | PA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS024198L | PA | Yes |
Addresses
Primary practice location
606 Chester Pike
Crum Lynne, PA 19022
Mailing address
606 Chester Pike
Crum Lynne, PA 19022
Phone (610) 833-5588
Other providers in Crum Lynne, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.