NPIMap

Organization Active NPI

Mary Disa Allen, DDS, PC

  • Dentist
  • Roanoke, VA
National Provider Identifier
1144769837
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401414341 Issued in VA
Legal business name
MARY DISA ALLEN, DDS, PC
Practice address
6232 Peters Creek Rd
Roanoke, VA 24019-4026
Phone
(540) 362-3846
NPI assigned
Feb 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Authorized official

Name
Dr. Mary Disa Allen, DDS
Title
President
Phone
(540) 998-7843

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 0401414341 VA Primary

Addresses

Primary practice location

6232 Peters Creek Rd
Roanoke, VA 24019-4026

Mailing address

6232 Peters Creek Rd
Roanoke, VA 24019-4026
Phone (540) 362-3846

Other names 1

  • Allen Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

6232 Peters Creek Rd
Roanoke, VA 24019
Phone (540) 362-3846

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487116800000",
    "number": "1144769837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6232 PETERS CREEK RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240194026",
            "telephone_number": "540-362-3846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6232 PETERS CREEK RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240194026",
            "telephone_number": "540-362-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY DISA ALLEN, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-15",
        "last_updated": "2017-02-15",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARY DISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-998-7843",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401414341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allen Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; 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.