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DR. SUMMER KETRON ROARK D.D.S.
NPI 1083913198
Dentist - General Practice in Lubbock, TX

Active since March 15, 2011Opted out of Medicare · through Sep 15, 2027
5301 50TH ST STE 100, LUBBOCK, TX 79414(806) 793-3556 Get Directions Write a Review

NPPES record last updated: February 20, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Summer Ketron Roark D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SUMMER KETRON ROARK D.D.S. (NPI 1083913198) is an individual general practice provider in Lubbock, Texas, licensed in Texas (27872) and active in the NPI registry since March 2011. She has opted out of Medicare through September 15, 2027 and remains eligible to order and refer and maintains a secondary practice location in Floydada.

NPPES Registry Identity

NPI1083913198
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDR. SUMMER KETRON ROARKCredential: D.D.S.
Location Address5301 50TH ST STE 100Lubbock, TX 79414-5834
Mailing Address4905 78th StLubbock, TX 79424-3103 · (806) 928-2080
Phone(806) 793-3556
Sole ProprietorYes
Enumeration DateMarch 15, 2011
Last NPPES UpdateFebruary 20, 2025
NPPES CertifiedFebruary 20, 2025
✔ NPI 1083913198 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in TX · 27872
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
5301 50TH ST STE 100, Lubbock, TX 79414
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Secondary Practice Location 1

Location 1508 S 2nd StFloydada, TX 79235-3208 · Phone (806) 983-2100

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Summer Ketron Roark D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 15, 2015 through September 15, 2027.

Opt-Out Effective DateSeptember 15, 2015
Opt-Out In Effect ThroughSeptember 15, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 79414 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAY C. ADKINS, DDS
Dentist
5301 50TH ST STE 100
LUBBOCK, TX 79414
Lubbock County (806) 793-3556

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Summer Roark's NPI number?

The NPI number for Summer Roark is 1083913198. It was assigned to this individual provider in the NPPES registry on March 15, 2011.

Where is Summer Roark located?

Summer Roark practices at 5301 50th St Ste 100, Lubbock, TX 79414. The listed phone number is (806) 793-3556.

What is Summer Roark's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Summer Roark enrolled in Medicare?

No. Summer Roark has opted out of Medicare through September 15, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Summer Roark was last updated on February 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.