Jerrick W. Rose, D.M.D.

Pediatric Dentistry · Jackson, MS

Individual Active NPI

NPI number 1801150958

Practice location

2500 N State St
Jackson, MS 39216
Phone
(601) 984-6100
Fax
(601) 815-5837

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NPI record

NPI
1801150958
Entity type
Individual (Type 1)
Enumeration date
July 3, 2012
Last updated
June 13, 2018
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pediatric Dentistry Primary 1223P0221X PEDO-482-14 MS
Dentist 122300000X 3662-12 MS
Pediatric Dentistry 1223P0221X 3662-12 MS

Mailing address

603 Southern Oaks Dr
Florence, MS 39073-9456
Phone
(601) 941-6237
Fax
(601) 815-5837

About Dr. Rose

Jerrick W. Rose, D.M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Pediatric Dentistry (code 1223P0221X). The practice location is 2500 N State St, Jackson, MS 39216. The NPI number 1801150958 was assigned on July 3, 2012 and the record was last updated on June 13, 2018.

Dr. Rose lists 3 licenses in the registry: #PEDO-482-14 (MS) for Pediatric Dentistry; #3662-12 (MS) for Dentist; #3662-12 (MS) for Pediatric Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jerrick W. Rose, D.M.D.?

The NPI number is 1801150958.

What is the phone number of Dr. Rose?

The phone number listed for the practice location is (601) 984-6100.

Where is Dr. Rose located?

2500 N State St, Jackson, MS 39216.

What is the taxonomy code for Dr. Rose?

The primary taxonomy code is 1223P0221X – Pediatric Dentistry; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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