TISHA ROSS (NPI# 1144252578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144252578 |
| Entity Type | Individual |
| Full Name | TISHA ROSS |
| Credential | DDS |
| Practice Address |
2230 Towne Lake Pkwy Bldg 1300 Ste 100 Woodstock GA 30189 |
| Practice Telephone | 6784455444 |
| Practice Fax Number | 6784455552 |
| Mailing Telephone | 6784455444 |
| Mailing Fax Number | 6784455552 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2017-02-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 012802 | GA | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DN012802 | GA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922207570 | Tisha Lyne Ross | Counselor | 4436 Nw 50th St, Oklahoma City, OK 73112-2212 | 2007-07-13 |
| Street Address |
2230 TOWNE LAKE PKWY BLDG 1300 STE 100 |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033108121 | Romualda S Klicius | Pediatrics | 2230 Towne Lake Pkwy, Building 300, Suite 100, Woodstock, GA 30189-5540 | 2005-10-20 |
| 1316574551 | Jane Schutter | Behavioral Analyst | 2230 Towne Lake Pkwy, Woodstock, GA 30189-5540 | 2020-03-26 |
| 1225569437 | New Ways Pain Management | Radiology | 2230 Towne Lake Pkwy, Bldg, No. 900, Suite 250 & 150, Woodstock, GA 30189-5540 | 2017-03-21 |
| 1487047791 | Tl Dental Group, LLC | Dentist | 2230 Towne Lake Pkwy, Bldg. 100, Suite 100, Woodstock, GA 30189-5540 | 2015-03-11 |
| 1952712390 | Connect Hearing, Inc. | Audiologist | 2230 Towne Lake Pkwy, Building 800 Ste 100, Woodstock, GA 30189-5540 | 2014-05-19 |
| 1851656151 | Caroline Michelle Malloy | Physical Therapist | 2230 Towne Lake Pkwy, Bldg 1200-100, Woodstock, GA 30189-5540 | 2012-07-12 |
| 1649531344 | Donaco Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 2230 Towne Lake Pkwy, Bldg 200 Ste 100, Woodstock, GA 30189-5540 | 2012-05-30 |
| 1295015709 | Kunjan Patel | Dentist | 2230 Towne Lake Pkwy, Bldg 1300 Suite 100, Woodstock, GA 30189-5540 | 2011-08-29 |
| 1326340407 | John Iaculli | Dentist | 2230 Towne Lake Pkwy, Building 1100, Ste 100, Woodstock, GA 30189-5540 | 2010-11-23 |
| 1326349945 | Family Orthodontics of Ws, LLC | Dentist | 2230 Towne Lake Pkwy, Building 1100, Ste 100, Woodstock, GA 30189-5540 | 2010-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494356 | Susan Iruku | Pharmacist | 12050 Ga-92 #112, Woodstock, GA 30189 | 2020-10-15 |
| 1598267437 | Kelly Sierra | Nurse Practitioner | 100 Stoneforest Dr Ste 300, Woodstock, GA 30189 | 2018-03-07 |
| 1548770449 | Chandra Johnson | Nurse Practitioner | 295 Molly Lane Ste 150, Woodstock, GA 30189 | 2017-10-05 |
| 1083133912 | Amanda Bostock Sowisdral | Physician Assistant | 250 Parkbrooke Pl Ste 300, Woodstock, GA 30189 | 2017-09-12 |
| 1780101659 | Laura C Koch Woodstock LLC Dba Fountain View Dentistry | Dentist | 1816 Eagle Drive, Building 200-a, Woodstock, GA 30189 | 2017-08-23 |
| 1265954788 | Vicky Morton Bryan | Nurse Practitioner | 422 Sycamore Trail, Woodstock, GA 30189 | 2017-07-17 |
| 1063933588 | Marietta Eye Clinic, Pa | Optometrist | 2990 Eagle Dr Ste 110, Woodstock, GA 30189 | 2017-07-06 |
| 1275914749 | Nrup Tolat | Podiatrist | 100 Stoneforest Dr Ste 120, Woodstock, GA 30189 | 2015-06-10 |
| 1558781534 | Mary Jansson Carmon | Nurse Practitioner | 1000 Towne Lake Pkwy, Woodstock, GA 30189 | 2014-04-17 |
| 1518388941 | Afc Physicians of Georgia, PC | General Practice | 6440 Bells Ferry Rd, Woodstock, GA 30189 | 2014-01-03 |
| Find all providers in zip 30189 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336296029 | Shiva Hejazi-werner | Dentist | 250 Parkbrooke Pl, Suite 250, Woodstock, GA 30189-6400 | 2007-01-04 |
| 1255439840 | Carlos A Garza Gongora | Dentist | 2320 Towne Lake Parkway, Building 1300 Ste 100, Woodstock, GA 30189 | 2006-09-20 |
| 1194746610 | Claudia E. Tomaselli, D.m.d., P.C. | Dentist | 375 Parkway 575, Suite 100, Woodstock, GA 30188-6439 | 2006-07-21 |
| 1316207996 | Travis Kimathi Dds PC | Dentist | 375 Parkway 575, #100, Woodstock, GA 30188-6439 | 2012-05-17 |
| 1295015709 | Kunjan Patel | Dentist | 2230 Towne Lake Pkwy, Bldg 1300 Suite 100, Woodstock, GA 30189-5540 | 2011-08-29 |
| 1346540432 | Park Pediatric Dentistry of Woodstock, LLC | Dentist | 1816 Eagle Dr, Suite 200-c, Woodstock, GA 30189-8272 | 2010-10-24 |
| 1932375128 | Menka Malhotra | Dentist | 2230 Towne Lake Parkway, Building 1300, Ste 100, Woodstock, GA 30189-5524 | 2008-05-07 |
| 1679697064 | Charles Oakley Coulter | Dentist | 2230 Towne Lake Parkway, Building 1300 Suite 100, Woodstock, GA 30189 | 2007-03-19 |
| 1710022942 | Julius Park | Dentist | 1816 Eagle Dr, 200-c, Woodstock, GA 30189-8272 | 2007-02-21 |
| 1649335746 | Todd Asarch | Dentist | 2230 Towne Lake Pkwy, Bldg 1300 Ste 100, Woodstock, GA 30189 | 2006-12-27 |
| Find all providers in WOODSTOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.