Brandi Rachelle Roach, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3363 Issued in AR

Practice address

2707 W Huntsville Ave
Springdale, AR 72762-7723

Phone

(479) 756-8631

Fax

(479) 751-7892

NPI assigned

Oct 27, 2006

Sex

Female

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 3

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Charles a. Hanby DDS PC

  • General Practice Dentistry
  • Springdale, AR
  • NPI 1093802209
  NPD (past)
• James S. Parham, D.D.S. P.a.

  • Dentist
  • Springdale, AR
  • NPI 1376970178
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598840340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 W HUNTSVILLE AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727627723",
            "telephone_number": "479-756-8631",
            "fax_number": "479-751-7892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 W HUNTSVILLE AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727627723",
            "telephone_number": "479-756-8631",
            "fax_number": "479-751-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "BRANDI",
        "middle_name": "RACHELLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA",
            "identifier": "3363",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "58250",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1317596",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Rena Rink, PMHNP
• Miranda Rios
• Peter Anthony Ritchie, DDS
• Thomas Neal Ritter, PHD
• Jennifer Lyn Rizzo, MHPP
• Ciara Robbins
• Stephanie Robbins, APRN
• Robert Petrino, MD, PA
• Robert Stark DDS PA
• Ashley Marie Roberts

• General Practice Dentistry in Springdale, AR
• Providers in Springdale, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.