NPIMap

Organization Active NPI

Tremont Road Dental, PC

  • General Practice Dentistry
  • Roanoke, VA
National Provider Identifier
1669871968
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TREMONT ROAD DENTAL, PC
Practice address
5002 Airport Rd NW
Unit 130
Roanoke, VA 24012-1607
Phone
(770) 916-5031
NPI assigned
Aug 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Authorized official

Name
Michelle Jacomino
Title
Director of Payor Relations
Phone
(770) 916-5036

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X

Addresses

Primary practice location

5002 Airport Rd NW
Unit 130
Roanoke, VA 24012-1607

Mailing address

1090 Northchase Pkwy SE
Suite 150
Marietta, GA 30067-6405

Other names 1

  • Spencer Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spencer Dental18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

5002 Airport Rd NW
Ste 130
Roanoke, VA 24012
Phone (540) 362-5437

NPI Registry JSON

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653609600000",
    "number": "1669871968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 NORTHCHASE PKWY SE",
            "address_2": "SUITE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300676405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 AIRPORT RD NW",
            "address_2": "UNIT 130",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240121607",
            "telephone_number": "770-916-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREMONT ROAD DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-22",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A",
        "authorized_official_last_name": "JACOMINO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR OF PAYOR RELATIONS",
        "authorized_official_telephone_number": "770-916-5036"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spencer Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.