Barry Wolfe, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

041004587 Issued in VA

Practice address

4405 Starkey Rd Ste a
Roanoke, VA 24018-0616

Phone

(540) 772-2913

Fax

(540) 989-6623

NPI assigned

Jan 24, 2007

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

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

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.

• Carilion Medical Center

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1730123472
  Medicare reassignment NPD
• Carilion Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Hardy, VA
  • NPI 1073324810
  NPD
• Carilion Medical Center

  • Dental Clinic/Center
  • Roanoke, VA
  • NPI 1114399276
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669527214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 AVENHAM AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141408",
            "telephone_number": "540-985-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 STARKEY RD STE A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180616",
            "telephone_number": "540-772-2913",
            "fax_number": "540-989-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "041004587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS CLUE SHIELD",
            "identifier": "077257",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan H Witt, LCSW
• Mary Jane Witter, CPNP
• Susan Wohlford, M.S., CCC-SLP
• Kyle Woisard, MD
• Phyllis J Wolf, LPCS
• Stephanie Wolfe, RD
• Paul R Wolff, M.D.
• Paula Marlene Wolfteich, PH.D.
• Mason Wolk, DO
• Ashley W Woltz, FNP-C

• Periodontics in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Periodontics in Virginia

• 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.