Active NPI
Charles Roberts, D.M.D.
- General Practice Dentistry
- Lubbock, TX
National Provider Identifier
1396158333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 32662
- Practice address
- 6417 34TH St
Ste 400
Lubbock, TX 79407 - Phone
- (806) 370-2005
- NPI assigned
- Jun 7, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2014016152 | MO | |
| General Practice Dentistry | 1223G0001X | 32662 | TX | Primary |
Addresses
Primary practice location
6417 34TH St
Ste 400
Lubbock, TX 79407
Mailing address
6417 34TH St
Ste 400
Lubbock, TX 79407
Phone (806) 370-2005
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32662 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670457600000",
"number": "1396158333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6417 34TH ST",
"address_2": "STE 400",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "79407",
"telephone_number": "806-370-2005",
"fax_number": "806-370-2014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6417 34TH ST",
"address_2": "STE 400",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "79407",
"telephone_number": "806-370-2005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-07",
"last_updated": "2022-12-08",
"certification_date": "2022-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "2014016152",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "32662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
- Robert J. Coolbaugh, DC, Dba Lubbock Accident and Injury Rehab
- Robert P. Schmid, MD, PA
- Robert W Perry, Inc.
- Robert W. Buchanan DC PA
- Breanna Roberts, LMSW
- Kasey Leigh Roberts, LVN
- Kelsey Roberts, MS, CCC-SLP
- Kynzi Roberts, BS, LCDC, CAC III
- Tyler Roberts, MSN, APRN, FNP-C
- Donald Jack Robertson, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.