Individual provider Active NPI

Roger David Urlaub, DDS

  • Dentist
  • Raleigh, NC
National Provider Identifier
1356431415
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6886 Issued in NC
Practice address
10941 Raven Ridge Rd
Suite 115
Raleigh, NC 27614-6487
Phone
(919) 870-1201
Fax
(919) 532-0306
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6886 NC Primary

Addresses

Primary practice location

10941 Raven Ridge Rd
Suite 115
Raleigh, NC 27614-6487

Mailing address

10941 Raven Ridge Rd
Suite 115
Raleigh, NC 27614-6487
Phone (919) 870-1201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150728003078 NC Order and Referring Only - DentistPractitioner - Dentist 5193039741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6886NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Roger D Urlaub DDS PA Past Accepting new patients
Londry & Modlin Xiii DDS PLLC PastSince Sep 5, 2023 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356431415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10941 RAVEN RIDGE RD",
            "address_2": "SUITE 115",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276146487",
            "telephone_number": "919-870-1201",
            "fax_number": "919-532-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10941 RAVEN RIDGE RD",
            "address_2": "SUITE 115",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276146487",
            "telephone_number": "919-870-1201",
            "fax_number": "919-532-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URLAUB",
        "first_name": "ROGER",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "6886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.