Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jerrick W Rose, DMD

Individual provider Dentist · NPI 1801150958

Jerrick W Rose, DMD is a Dentist in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2012.

Licensed in
MS
In the registry since
2012
Specialties on file
3
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

2500 N State St
Jackson, MS 39216
Phone: (601) 984-6100
Fax: (601) 815-5837
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence PEDO-482-14 (MS)
Dentist Taxonomy 122300000X · Licence 3662-12 (MS)
Pediatric Dentistry Taxonomy 1223P0221X · Licence 3662-12 (MS)

Record details

NPI number1801150958
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedJuly 3, 2012
Last updated in NPPESJune 13, 2018
Mailing address603 Southern Oaks Dr, Florence, MS 39073-9456

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