NPIMap

Organization Active NPI

Roark Dental Services PSC

  • General Practice Dentistry
  • Bayamon, PR
National Provider Identifier
1124215470
Registry record updated Nov 17, 2008
On this page

Key facts

NPPES NPI Registry
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2008

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

Authorized official

Name
Dr. Dominick Garrett Roark, DMD
Title
Owner
Phone
(787) 948-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 2379 PR Primary

Addresses

Primary practice location

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

Mailing address

E-43 Alamo Drive
Guaynabo, PR 00969

National Provider Directory

National Provider Directory

NPI Registry JSON

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": []
}

Other providers in Bayamon, PR

Sources for this page

  • 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.