Provider Demographics
NPI:1922028331
Name:DAVID S. ROSS DDS PC
Entity Type:Organization
Organization Name:DAVID S. ROSS DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-656-9565
Mailing Address - Street 1:4949 BATTERY LN
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4942
Mailing Address - Country:US
Mailing Address - Phone:301-656-9565
Mailing Address - Fax:301-907-9546
Practice Address - Street 1:4949 BATTERY LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4942
Practice Address - Country:US
Practice Address - Phone:301-656-9565
Practice Address - Fax:301-907-9546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD065491223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD087507Medicare PIN
MDT30868Medicare UPIN