Active NPI
Adam Pink, DDS
- Dentist
- Roanoke, VA
National Provider Identifier
1104470657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401418246
- Practice address
- 4910 Valley View Blvd NW Ste 201
Roanoke, VA 24012-2022 - Phone
- (540) 563-5858
- NPI assigned
- Aug 1, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401418246 | VA | Primary |
Addresses
Primary practice location
4910 Valley View Blvd NW Ste 201
Roanoke, VA 24012-2022
Mailing address
696 Scarlet Dr
Daleville, VA 24083-3175
Phone (719) 290-0478
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401418246 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787788800000",
"number": "1104470657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "696 SCARLET DR",
"city": "DALEVILLE",
"state": "VA",
"postal_code": "240833175",
"telephone_number": "719-290-0478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4910 VALLEY VIEW BLVD NW STE 201",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240122022",
"telephone_number": "540-563-5858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PINK",
"first_name": "ADAM",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-01",
"last_updated": "2026-08-27",
"certification_date": "2026-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401418246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, VA
- Sadie Margaret Pilgreen, PA
- Ariana Pineda, COTA, PTA
- Michole M Pineda, MD
- Romil Pineda
- Ramon Antonio Pineyro Poueriet, M.D.
- Pinnacle Treatment Services of Roanoke, LLC
- Pinnacle Treatment Services of Roanoke, LLC
- Pinnacle Treatment Services of Roanoke, LLC
- Pinnacle Treatment Services of Roanoke, LLC
- Pinnacle Treatment Services of Roanoke, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.