SAMUEL SCROGGINS DMD NPI 1487742375

NPI Information

  • NPI: 1487742375
  • Provider Name: SAMUEL SCROGGINS, DMD
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3580 KEAGY RD SW
    ROANOKE, VA
    ZIP 24018
  • Phone: (540) 989-5257

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NPI Details

Samuel Scroggins, DMD is an oral and maxillofacial surgery dentist in Roanoke, VA with 20 years of experience. The provider is 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. Samuel Scroggins, DMD NPI is 1487742375. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduation Year:2005

The provider's business location address is:

3580 KEAGY RD SW
ROANOKE, VA
ZIP 24018-152
Phone: (540) 989-5257
Fax: (540) 989-5259

The NPI 1487742375 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/10/2006 and was last updated on 12/30/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial Surgery0401413811VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1009911387MEDICAIDALABAMA
2510-06443OTHERALABAMABLUE CROSS BLUE SHIELD
351529738OTHERALABAMABLUE CROSS#-EASTERN DENTA
4009932141MEDICAIDALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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