Individual provider Active NPI

Michelle Jeanette Mayerchak, DMD

  • Dentist
  • Roanoke, VA
National Provider Identifier
1376510636
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401008729 Issued in VA
Practice address
4207 Colonial Ave
Roanoke, VA 24018-4045
Phone
(540) 989-4549
NPI assigned
Mar 7, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401008729 VA Primary

Addresses

Primary practice location

4207 Colonial Ave
Roanoke, VA 24018-4045

Mailing address

5105 Skeens Ridge Rd
Big Stone Gap, VA 24219-4055
Phone (276) 523-3421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401008729VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1376510636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 SKEENS RIDGE RD",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "242194055",
            "telephone_number": "276-523-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 COLONIAL AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184045",
            "telephone_number": "540-989-4549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYERCHAK",
        "first_name": "MICHELLE",
        "middle_name": "JEANETTE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401008729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 13, 2026; 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.