Charles Dudley Parks, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401008066 Issued in VA

Practice address

5004 Brambleton Ave
Roanoke, VA 24018-4642

Phone

(540) 774-1019

NPI assigned

Jan 11, 2007

Last updated

May 21, 2020By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Gary a. Roach, DDS, LTD

  • Dentist
  • Roanoke, VA
  • NPI 1093044406
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1538219803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6635 MOUNT CHESTNUT RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240188111",
            "telephone_number": "540-989-9305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5004 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184642",
            "telephone_number": "540-774-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "CHARLES",
        "middle_name": "DUDLEY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401008066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL SECURITY NUMBER",
            "identifier": "$$$$$$$$$",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Wayne Parker, MSW, LCSW
• Cierra Parker
• Grant S Parker, DO
• Jordyn Woods Parker, LPC
• Sarah Parker, COTA
• Ilona Edyta Parks, D.O.
• Parkway Pediatric Dentistry, PLLC (Parkway Pediatric Dentistry)
• Kistin Parlee, RN
• Dianna B Parrish, LCSW
• Kayla Marie Parrish, M.S. CCC-SLP

• General Practice Dentistry in Roanoke, VA
• Providers in Roanoke, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.