Organization Active NPI

Straight Smiles of Roanoke, PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Roanoke, VA
National Provider Identifier
1962706754
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
STRAIGHT SMILES OF ROANOKE, PLLC
Practice address
1502 Williamson Rd NE
Suite a
Roanoke, VA 24012-5130
Phone
(540) 206-2203
Fax
(540) 400-0525
NPI assigned
Jan 7, 2011
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Jenell Stringer
Title
Manager, Licensing & Credentialing
Phone
(615) 750-0343

National Provider Directory

National Provider Directory

Locations

1502 Williamson Rd NE
Ste A
Roanoke, VA 24012
Phone (540) 206-2203

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

NPPES NPI Registry

Primary practice location

1502 Williamson Rd NE
Suite a
Roanoke, VA 24012-5130

Mailing address

16 Arcade Unit 198747
Nashville, TN 37219-1994
Phone (615) 750-0343

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
208806MedicaidVA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 11, 2013.

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370908800000",
    "number": "1962706754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ARCADE UNIT 198747",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372191994",
            "telephone_number": "615-750-0343",
            "fax_number": "615-986-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 WILLIAMSON RD NE",
            "address_2": "SUITE A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240125130",
            "telephone_number": "540-206-2203",
            "fax_number": "540-400-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRAIGHT SMILES OF ROANOKE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-07",
        "last_updated": "2013-06-11",
        "status": "A",
        "authorized_official_last_name": "STRINGER",
        "authorized_official_first_name": "JENELL",
        "authorized_official_title_or_position": "MANAGER, LICENSING & CREDENTIALING",
        "authorized_official_telephone_number": "615-750-0343"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208806",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.