Parker Roustio, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.034489 Issued in IL

Practice address

1002 E Wesley Dr Ste 200
O Fallon, IL 62269-6143

Phone

(618) 628-7080

Fax

(618) 628-9235

NPI assigned

Jun 23, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Parker Roustio DMD Inc.

  • Dentist
  • O'Fallon, IL
  • NPI 1215899091
  NPD Authorized official
• Harold J Bean Jr DDS PC

  • General Practice Dentistry
  • O'Fallon, IL
  • NPI 1801909270
  NPD (past)

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1841976842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8422 BRAESWOOD ESTATES DR",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622694247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 E WESLEY DR STE 200",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622696143",
            "telephone_number": "618-628-7080",
            "fax_number": "618-628-9235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSTIO",
        "first_name": "PARKER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-23",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.034489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah Madison Roman
• Ronald Weems Jr. P.C. (Shiloh Family Dental)
• William Carl Rook, M.A., LCPC
• Elaina Rossman
• Caroline Roti, DMD
• Scott R. Roustio, MD
• Stephanie Roxby, LCSW
• Andrea M Russell, MS, CCC-SLP
• Laine Russell
• Renee N Rutherford, PA-C

• General Practice Dentistry in O'Fallon, IL
• Providers in O'Fallon, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.