Individual provider Active NPI

Linda Garbacik Till, D.D.S.

  • Periodontics
  • Roanoke, VA
National Provider Identifier
1851449912
Registry record updated Apr 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
7353 Issued in VA
Practice address
3090 Electric Rd
Suite a
Roanoke, VA 24018-3531
Phone
(540) 772-3940
Fax
(540) 772-3974
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 7353 VA Primary

Addresses

Primary practice location

3090 Electric Rd
Suite a
Roanoke, VA 24018-3531

Mailing address

3090 Electric Rd
Suite a
Roanoke, VA 24018-3531
Phone (540) 772-3940

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150914002384 VA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1658688312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7353VAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271030400000",
    "number": "1851449912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 ELECTRIC RD",
            "address_2": "SUITE A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183531",
            "telephone_number": "540-772-3940",
            "fax_number": "540-772-3974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 ELECTRIC RD",
            "address_2": "SUITE A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183531",
            "telephone_number": "540-772-3940",
            "fax_number": "540-772-3974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILL",
        "first_name": "LINDA",
        "middle_name": "GARBACIK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "7353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.