Southwest Virginia Oral & Maxillofacial Surgery, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0401413811 Issued in VA

Legal business name

SOUTHWEST VIRGINIA ORAL & MAXILLOFACIAL SURGERY, PLLC

Practice address

3580 Keagy Rd SW
Roanoke, VA 24018-1152

Phone

(540) 989-5257

Fax

(540) 989-5259

NPI assigned

Mar 12, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Samuel E Scroggins, DMDNPI 1487742375

Title

LLC Member

Phone

(540) 989-5257

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel Scroggins, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Roanoke, VA
  • NPI 1487742375
  Medicare reassignment NPD Authorized official
• Daniel Enrique Perez Osorio, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Roanoke, VA
  • NPI 1508097817
  NPD
• Mary Katherine Spinella, MD, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Lexington, VA
  • NPI 1538723986
  NPD

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1972996197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 KEAGY RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181152",
            "telephone_number": "540-989-5257",
            "fax_number": "540-989-5259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 KEAGY RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181152",
            "telephone_number": "540-989-5257",
            "fax_number": "540-989-5259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST VIRGINIA ORAL & MAXILLOFACIAL SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-12",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "SCROGGINS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "LLC MEMBER",
        "authorized_official_telephone_number": "540-989-5257",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401413811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southwest Medical Clinic
• Southwest Virginia Center for Cosmetic Plastic & Recon Surgery
• Southwest Virginia Eye Center, PLLC (Southwest Virginia Eye Center)
• Southwest Virginia Nephrology LLC
• Southwest Virginia Nephrology Medicine, PC
• Ann B Sowers, M.D.
• Steven E. Sowers, D.D.S.
• Camille Suzanne Spain, MS, CCC-SLP
• Angel U Spangler, COTA
• Gwendolyn Williams Spangler, NP-C

• Oral and Maxillofacial Surgery (Dentist) in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.