Individual provider Active NPI

Kaine Kenneth Swenson Stokes, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Roanoke, VA
National Provider Identifier
1326236845
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
0401415351 Issued in VA
Practice address
3229 Brandon Ave SW
Roanoke, VA 24018-1547
Phone
(540) 362-5900
NPI assigned
Oct 10, 2007
Last updated
Jan 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 0438000365 VA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 0401415351 VA Primary

Addresses

Primary practice location

3229 Brandon Ave SW
Roanoke, VA 24018-1547

Mailing address

3229 Brandon Ave SW
Roanoke, VA 24018-1547
Phone (540) 362-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180702001170 VA Practitioner - Maxillofacial SurgeryPractitioner - Dentist 6608122833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Dentist
Education
University of Minnesota School of Dentistry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roanoke Oral Surgery IncGroup PAC ID 1456314681, 4 clinicians

Practice addresses (Care Compare)

6035 Peters Creek Rd
Roanoke, VA 24019-4029
Phone (540) 362-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401415351VAMDOral and Maxillofacial Surgery (Dentist)
0438000365VAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Aug 5, 2022 Accepting new patients
Roanoke Oral Surgery, Inc. Oral and Maxillofacial Surgery CurrentSince Jul 1, 2018 Accepting new patients
Carilion Medical Center CurrentSince Aug 5, 2022 Accepting new patients

Locations

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

3229 Brandon Ave SW
Roanoke, VA 24018
Phone (540) 362-5900

6035 Peters Creek Rd
Roanoke, VA 24019
Phone (540) 362-5900

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1326236845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3229 BRANDON AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181547",
            "telephone_number": "540-362-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3229 BRANDON AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181547",
            "telephone_number": "540-362-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOKES",
        "first_name": "KAINE",
        "middle_name": "KENNETH SWENSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-10",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0438000365",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401415351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.