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ROANOKE ORAL SURGERY, INC.
NPI 1104007384
Dentist - Oral and Maxillofacial Surgery in Roanoke, VA

Active since November 16, 2007
6027 PETERS CREEK RD, ROANOKE, VA 24019(540) 362-5900(540) 366-5131 Get Directions Write a Review

NPPES record last updated: November 16, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Roanoke Oral Surgery, Inc. NPPES

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

ROANOKE ORAL SURGERY, INC. (NPI 1104007384) is a healthcare organization registered as an oral and maxillofacial surgery in Roanoke, Virginia and active in the NPI registry since November 2007. The organization lists James T. Mcclung, President, as its authorized official.

NPPES Registry Identity

NPI1104007384
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameROANOKE ORAL SURGERY, INC.
Location Address6027 PETERS CREEK RDRoanoke, VA 24019-4029
Mailing AddressPo Box 7889Roanoke, VA 24019-0889 · (540) 362-5900 · Fax (540) 366-5131
Phone(540) 362-5900
Fax(540) 366-5131
Organization SubpartNo
Authorized OfficialJames T. McclungPresident · (540) 362-5900
Enumeration DateNovember 16, 2007
✔ NPI 1104007384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in VA · 0401004673
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
6027 PETERS CREEK RD, Roanoke, VA 24019
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Roanoke Oral Surgery, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Roanoke Oral Surgery, Inc., which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Albert Parulis, DMD
Oral Surgery
NPI 1003886912
6027 PETERS CREEK RD
Roanoke, VA 24019
(540) 362-5900
✔ PECOS✔ Accepts MedicareSame address
Kaine Stokes, DDS
Maxillofacial Surgery
NPI 1326236845
3229 BRANDON AVE SW
Roanoke, VA 24018
(540) 362-5900
✔ PECOS✔ Accepts Medicare5.6 mi
Nicole Reddout, DMD
Oral Surgery
NPI 1790001436
1647 ADMIRAL TAUSSIG BLVD
Norfolk, VA 23511
(757) 953-8605
✔ PECOS✔ Accepts Medicare204 mi
Jason Margolis, DMD
Oral Surgery
NPI 1437315702
621 SOUTH NEW BALLAS ROAD SUITE 16 A
St. Louis, MO 63141
(314) 251-6725
✔ PECOS✔ Accepts Medicare579 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Roanoke Oral Surgery, Inc.'s NPI number?

The NPI number for Roanoke Oral Surgery, Inc. is 1104007384. It was assigned to this organization in the NPPES registry on November 16, 2007.

Where is Roanoke Oral Surgery, Inc. located?

Roanoke Oral Surgery, Inc. is located at 6027 Peters Creek Rd, Roanoke, VA 24019. The listed phone number is (540) 362-5900.

What is Roanoke Oral Surgery, Inc.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Roanoke Oral Surgery, Inc. enrolled in Medicare?

Yes. Roanoke Oral Surgery, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Roanoke Oral Surgery, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Roanoke Oral Surgery, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Oral Surgery (3) and Maxillofacial Surgery (1). Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Roanoke Oral Surgery, Inc. was last updated on November 16, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.