Samuel Scroggins, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0401413811 Issued in VA

Practice address

3580 Keagy Rd SW
Roanoke, VA 24018-1152

Phone

(540) 989-5257

Fax

(540) 989-5259

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Oral SurgeryAlso: Maxillofacial Surgery

Education

University of Alabama School of Medicine, 2005

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southwest Virginia Oral & Maxillofacial Surgery, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Roanoke, VA
  • NPI 1972996197
  Medicare reassignment NPD Authorized official
• Blue Ridge Oral Surgery, Inc.

  dba Blue Ridge Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Fishersville, VA
  • NPI 1710013446
  Medicare reassignment NPD

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1487742375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 KEAGY RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181152",
            "telephone_number": "540-989-5257",
            "fax_number": "540-989-5259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 KEAGY RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181152",
            "telephone_number": "540-989-5257",
            "fax_number": "540-989-5259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCROGGINS",
        "first_name": "SAMUEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401413811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009911387",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "510-06443",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS#-EASTERN DENTA",
            "identifier": "51529738",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009932141",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carla Jeanette Scott, M.S., SLP
• Dianna Lynn Scott, FNP
• Elizabeth Harkness Scott, DPT
• Joseph Anthony Scott, LCSW
• Tina Lynn Scott
• Deborah M Seagraves, LPC, LMFT
• Jesse B Seamon, MD
• Sean Eschenbach, DDS, PLLC (Eschenbach Family Dentistry)
• Carole A Sease, MSOTRL
• Katelyn Ann Seay, FNP

• Oral and Maxillofacial Surgery (Dentist) in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.