NPIMap

Organization Active NPI

CLQ&P Dentistry PLLC

  • Dentist
  • Roanoke, VA
National Provider Identifier
1740995471
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CLQ&P DENTISTRY PLLC
Practice address
1930 Electric Rd
Roanoke, VA 24018-1621
Phone
(540) 989-1170
NPI assigned
Jan 17, 2023
Last updated
Jan 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Authorized official

Name
Mike Cole
Title
VP Insurance Plan Management
Phone
(727) 424-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

1930 Electric Rd
Roanoke, VA 24018-1621

Mailing address

1930 Electric Rd
Roanoke, VA 24018-1621

Other practice location 1

175 Market Ridge Ln
Daleville, VA 24083-3260
Phone (540) 992-1004

Other practice location 2

224 W Virginia Ave
Vinton, VA 24179-3318
Phone (540) 342-8756

National Provider Directory

National Provider Directory

Locations

175 Market Ridge Ln
Daleville, VA 24083
Phone (540) 784-4585

1930 Electric Rd
Roanoke, VA 24018
Phone (540) 766-4338

224 W Virginia Ave
Vinton, VA 24179
Phone (540) 342-8756

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1740995471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 ELECTRIC RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 ELECTRIC RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181621",
            "telephone_number": "540-989-1170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Market Ridge Ln",
            "address_purpose": "LOCATION",
            "city": "Daleville",
            "state": "VA",
            "postal_code": "240833260",
            "country_code": "US",
            "telephone_number": "540-992-1004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "224 W Virginia Ave",
            "address_purpose": "LOCATION",
            "city": "Vinton",
            "state": "VA",
            "postal_code": "241793318",
            "country_code": "US",
            "telephone_number": "540-342-8756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLQ&P DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "VP INSURANCE PLAN MANAGEMENT",
        "authorized_official_telephone_number": "727-424-2990"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 17, 2023; 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.