Roxanne Winebaugh, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019032747 Issued in IL

Practice address

309 Tamarack LN
O Fallon, IL 62269-2993

Phone

(618) 624-7200

NPI assigned

Jun 30, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Roxanne Dudovitz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1912524596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 TAMARACK LN",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692993",
            "telephone_number": "618-624-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 TAMARACK LN",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692993",
            "telephone_number": "618-624-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINEBAUGH",
        "first_name": "ROXANNE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2020018228",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019032747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROXANNE",
            "last_name": "DUDOVITZ",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Williams
• Amanda Lee Wilson, OTR/L
• Dominique Marie Wilson, MA, LCPC, CRC
• Tessa Wilson
• Tremiya Renae Winbush
• Margaret Winkeler, RN, IBCLC, CEIM
• Laurean Jada Winston, PA-C
• Jamie Winters
• Zachariah Wisnasky, RN
• Jacob Samuel Witt, M.D.

• Dentist in O Fallon, IL
• Providers in O Fallon, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.