Individual provider Active NPI

Daniel Enrique Perez Osorio, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Roanoke, VA
National Provider Identifier
1508097817
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
0401419343 Issued in VA
Practice address
3580 Keagy Rd SW
Roanoke, VA 24018-1152
Phone
(540) 989-5257
NPI assigned
Aug 4, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 0401419343 VA Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X F-24895 TX

Addresses

Primary practice location

3580 Keagy Rd SW
Roanoke, VA 24018-1152

Mailing address

3580 Keagy Rd SW
Roanoke, VA 24018-1152
Phone (540) 989-5257

Other identifiers 1

IdentifierTypeStateIssuer
204989206MedicaidTX

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250825000129 VA Practitioner - Oral Surgery 5597801191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3580 Keagy Rd SW
Roanoke, VA 24018-1152

500 E John Carpenter Fwy
Suite 300
Irving, TX 75062-3969

54 S Medical Park Dr
Fishersville, VA 22939-2333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401419343VAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Oral Surgery, Inc. Oral and Maxillofacial Surgery CurrentSince Aug 1, 2025 Accepting new patients
Southwest Virginia Oral & Maxillofacial Surgery, PLLC Oral and Maxillofacial Surgery CurrentSince Mar 3, 2026 Accepting new patients

Locations

54 S Medical Park Dr
Fishersville, VA 22939
Phone (540) 886-2956

112 Houston St
Ste B
Lexington, VA 24450
Phone (540) 463-9166

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": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1508097817",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ OSORIO",
        "first_name": "DANIEL",
        "middle_name": "ENRIQUE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-04",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401419343",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "F-24895",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204989206",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.