Matthew C Roller DDS LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401412172 Issued in VA

Legal business name

MATTHEW C ROLLER DDS LLC

Practice address

251 Frontier Dr
Staunton, VA 24401-9174

Phone

(540) 886-3777

NPI assigned

Jan 28, 2014

Organization subpart

No

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

Authorized official

Name

Matthew Callender Roller, D.D.S

Title

Dentist

Phone

(540) 886-3777

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390867200000",
    "number": "1346663390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 FRONTIER DR",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244019174",
            "telephone_number": "540-886-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 FRONTIER DR",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244019174",
            "telephone_number": "540-886-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW C ROLLER DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-28",
        "last_updated": "2014-01-28",
        "status": "A",
        "authorized_official_last_name": "ROLLER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "CALLENDER",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "540-886-3777",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.