DR. GREGG LEE ROSE DDS NPI 1730243171

NPI Information

NPI: 1730243171
Provider Name: DR. GREGG LEE ROSE, DDS
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

Address:
1715 BROADMOOR DR
SUITE B
CHAMPAIGN, IL
ZIP 61821
Phone: (217) 352-7337
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DR. Gregg Lee Rose, DDS is a pediatric dentistry dentist in Champaign, IL. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Gregg Lee Rose, DDS NPI is 1730243171. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1715 BROADMOOR DR
SUITE B
CHAMPAIGN, IL
ZIP 61821-983
Phone: (217) 352-7337

The enumeration date for this NPI number is 12/20/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0221X	Dentist	Pediatric Dentistry	021.001507019.021040	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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