Roark Dental Services PSC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2379 Issued in PR

Legal business name

ROARK DENTAL SERVICES PSC

Practice address

Carr 167 KM 22.6
Oficina Dental Mypenmercado Pitusa Bayamon
Bayamon, PR 00959

Phone

(787) 288-5994

Fax

(787) 288-5994

NPI assigned

Oct 1, 2007

Last updated

Nov 17, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Dominick Garrett Roark, DMDNPI 1770688202

Title

Owner

Phone

(787) 948-5500

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dominick Roark, DMD

  • General Practice Dentistry
  • Guaynabo, PR
  • NPI 1770688202
  Authorized official Same address or phone

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226880000000",
    "number": "1124215470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E-43 ALAMO DRIVE",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 167 KM 22.6",
            "address_2": "OFICINA DENTAL MYPENMERCADO PITUSA BAYAMON",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-288-5994",
            "fax_number": "787-288-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROARK DENTAL SERVICES PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2008-11-17",
        "status": "A",
        "authorized_official_last_name": "ROARK",
        "authorized_official_first_name": "DOMINICK",
        "authorized_official_middle_name": "GARRETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-948-5500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Bayamon, PR
• Providers in Bayamon, PR by specialty
• General Practice Dentistry in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.