Roger Lee Myers, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN18207 Issued in FL

Practice address

180 Capulet Dr Ste 3
St Augustine, FL 32092-4541

Phone

(904) 299-2942

Fax

(904) 299-2943

NPI assigned

Aug 22, 2006

Last updated

Oct 15, 2024By 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

Opted out of Medicare

Yes, effective Jul 1, 2024 through Jul 1, 2028

Medicare enrollment (NPD)

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.

• Gateway Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • St Augustine, FL
  • NPI 1073336483
  NPD Authorized official
• St. Johns Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Saint Johns, FL
  • NPI 1710707328
  NPD Authorized official
• Cornerstone Oral and Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Valdosta, GA
  • NPI 1356983746
  NPD Authorized official
• Southern Georgia Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Hinesville, GA
  • NPI 1992977243
  NPD (past) Authorized official

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1962518829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 CAPULET DR STE 3",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320924541",
            "telephone_number": "904-299-2942",
            "fax_number": "904-299-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 CAPULET DR STE 3",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320924541",
            "telephone_number": "904-299-2942",
            "fax_number": "904-299-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "ROGER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN18207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MVP Support Services, LLC
• MVP Support Services, LLC
• Kasandra Leigh Myers-Bell, PT, DPT
• Kaitlyn Elizabeth Myers
• Kylee Myers
• Myeyedr Optometry of Florida, LLC (MyEyeDr.)
• Myeyedr Optometry of Florida, LLC
• Myeyedr Optometry of Florida, LLC
• Myeyedr. Optometry of Florida, LLC (MyEyeDr.)
• Sheyna Myntti, DPT

• Oral and Maxillofacial Surgery (Dentist) in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.