Summer Ketron Roark, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27872 Issued in TX

Practice address

5301 50TH St Ste 100
Lubbock, TX 79414-5834

Phone

(806) 793-3556

NPI assigned

Mar 15, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 15, 2015 through Sep 15, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jay C. Adkins, DDS

  • Dentist
  • Lubbock, TX
  • NPI 1811316086
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1083913198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 78TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794243103",
            "telephone_number": "806-928-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 50TH ST STE 100",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794145834",
            "telephone_number": "806-793-3556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "508 S 2nd St",
            "address_purpose": "LOCATION",
            "city": "Floydada",
            "state": "TX",
            "postal_code": "792353208",
            "country_code": "US",
            "telephone_number": "806-983-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROARK",
        "first_name": "SUMMER",
        "middle_name": "KETRON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-15",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• RJ Madsen Enterprises, LLC
• Aida Rjepaj, M.D.
• Piro Rjepaj, M.D.
• Allison Roach
• Staci Roark, BSN, RN, CA/CP SANE
• Jazzlyn Roberson
• Kerri Leanne Roberson, M.S., CCC-SLP
• Kevin Lee Roberson, M.S., CCC-SLP
• Robert F. Bloom, MD, PA
• Robert J Mamlok

• General Practice Dentistry in Lubbock, TX
• Providers in Lubbock, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.