Parkway Pediatric Dentistry, PLLC
Dentist, Pediatric Dentistry in Roanoke, VA. Organization (NPI-2).
NPI number1467052019
StatusActive
Last updated in NPPESNov 2, 2020
Details
- NPI
- 1467052019
- Entity type
- Organization (NPI-2)
- Legal business name
- Parkway Pediatric Dentistry, PLLC
- Organization subpart
- No
- Enumeration date
- Oct 31, 2020
- Certification date
- Nov 2, 2020
- Last updated
- Nov 2, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | – | – | Yes |
Other names
- Parkway Pediatric Dentistry (Doing Business As)
Practice location
3650 Colonial AveRoanoke, VA 24018-4004
Phone 540-989-3639
Mailing address
5907 Cavalier DrRoanoke, VA 24018-3863
Phone 701-212-7428
Authorized official
Ryan R Reopelle
Member
7012127428
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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