Bryan Patrick Roach, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

8774 Issued in NC

Practice address

Advanced Education in General Dentistry Program
2300 Ramsey St.
Fayetteville, NC 28301-3856

Phone

(910) 822-7029

Fax

(910) 482-5050

NPI assigned

Jun 4, 2009

Last updated

Jun 4, 2009By the provider in NPPES

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)

Enrolled

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244073600000",
    "number": "1881820843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ADVANCED EDUCATION IN GENERAL DENTISTRY PROGRAM",
            "address_2": "2300 RAMSEY ST.",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013856",
            "telephone_number": "910-822-7029",
            "fax_number": "910-482-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ADVANCED EDUCATION IN GENERAL DENTISTRY PROGRAM",
            "address_2": "2300 RAMSEY ST.",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013856",
            "telephone_number": "910-822-7029",
            "fax_number": "910-482-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "BRYAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-04",
        "last_updated": "2009-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "8774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elyse L. Roach, MA/CCC-SLP
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• Keturah Roach
• Sean Roach I
• Michelle L Roark, NP, RN

• Dentist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; 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.