COMMONWEALTH DENTAL CLINIC (NPI# 1144641309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144641309 |
| Entity Type | Organization |
| Organization Name | COMMONWEALTH DENTAL CLINIC |
| Practice Address |
1121 S Jefferson St Roanoke VA 24016-4703 |
| Mailing Address |
1618 W Main St Salem VA 24153-3116 |
| Practice Telephone | 5406850028 |
| Mailing Telephone | 5406850028 |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2013-12-13 |
| Authorized Official Name | GREGORY TODD HARVEY (PRESIDENT) |
| Authorized Official Telephone | 5406850028 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
0401410880 | VA | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Commonwealth Dental Clinic Inc. | 1121 S Jefferson St, Roanoke, Virginia 24016 |
| Street Address |
1121 S JEFFERSON ST |
| City | ROANOKE |
| State | VA |
| Zip Code | 24016-4703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518903921 | Robert C. Keeley | Internal Medicine | 1121 S Jefferson St, Roanoke, VA 24016-4703 | 2006-06-22 |
| 1497813430 | Advanced Foot and Ankle Center, Pllc | Podiatrist | 1121 S Jefferson St, Roanoke, VA 24016-4703 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134758329 | Davis Andrew Sugar | Student in an Organized Health Care Education/Training Program | 1 Riverside Circle, Suite 401, Roanoke, Va, 24016, Suite 401, Roanoke, VA 24016 | 2020-04-08 |
| 1356810659 | Susanne Tribble | Social Worker | 202 Wells Ave Nw, Roanoke, VA 24016 | 2018-11-15 |
| 1801305818 | Rena Lee Daye | Driver | 10 12th St. Sw, Roanoke, VA 24016 | 2017-09-21 |
| 1053841965 | Christin Elledge Clark | Nurse Practitioner | 1234 Franklin Road, Roanoke, VA 24016 | 2017-06-13 |
| 1235685884 | Helen Franck | Physical Therapist | 650 North Jefferson Street, Roanoke, VA 24016 | 2016-09-01 |
| 1457710238 | Frances Marie Gaeta | Social Worker | 360 Campbell Ave, Roanoke, VA 24016 | 2016-02-22 |
| 1982073292 | Sophie Mench Tranmer | Physical Therapist | 1421 Third St. Sw, Roanoke, VA 24016 | 2015-09-16 |
| 1982008181 | National Counseling Group, Inc | Psychiatry & Neurology | 20 Walnut Avenue, Roanoke, VA 24016 | 2014-10-17 |
| 1366858342 | National Counseling Group, Inc | Psychiatry & Neurology | 16 Walnut Avenue, Roanoke, VA 24016 | 2014-07-10 |
| 1427320878 | Kristen L. Jagger | Physical Medicine & Rehabilitation | 1015 First Street Sw Suite 2, Roanoke, VA 24016 | 2012-02-01 |
| Find all providers in zip 24016 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124514203 | R. Douglas Ross, Dds PC | Clinic/Center | 1602 Grandin Rd Sw, Roanoke, VA 24015-2308 | 2018-07-02 |
| 1912414251 | 6 Day Dental Group - Roanoke, Pllc | Clinic/Center | 200 Tx-114, Roanoke, TX 76262 | 2018-01-09 |
| 1780932277 | Harvey Dentistry Nrke | Clinic/Center | 5049 Valley View Blvd Nw Ste C, Roanoke, VA 24012-2075 | 2012-08-15 |
| 1235383019 | General Family Dentistry | Clinic/Center | 108 W Point St, Roanoke, AL 36274-1686 | 2008-11-06 |
| 1013575661 | Irby Dentistry | Clinic/Center | 3501 Franklin Rd Sw, Roanoke, VA 24014-2201 | 2019-05-30 |
| 1659844538 | Kfd Virginia Inc | Clinic/Center | 4903 Starkey Rd Ste 300, Roanoke, VA 24018-8525 | 2019-01-03 |
| 1114399276 | Carilion Medical Center | Clinic/Center | 2017 Jefferson St Sw, Roanoke, VA 24014-2419 | 2015-10-28 |
| 1700287596 | Kuumba Health and Wellness Center | Clinic/Center | 3716 Melrose Ave Nw, Roanoke, VA 24017-2716 | 2014-09-11 |
| 1578851002 | Young C. Park, Dds., PC | Clinic/Center | 623 Abney Rd, Roanoke, VA 24012-1257 | 2011-07-19 |
| 1205840956 | Carilion Medical Center | Clinic/Center | 2017 Jefferson St Sw, 2nd Floor, Roanoke, VA 24014-2419 | 2006-07-28 |
| Find all providers in ROANOKE | ||||
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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.