Provider Demographics
NPI:1033888631
Name:ROAM DENTAL PLLC
Entity Type:Organization
Organization Name:ROAM DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRGIL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BARBU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-495-9909
Mailing Address - Street 1:2661 INVITATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48363-2456
Mailing Address - Country:US
Mailing Address - Phone:248-495-9909
Mailing Address - Fax:
Practice Address - Street 1:47766 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317-3370
Practice Address - Country:US
Practice Address - Phone:248-495-9909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1649709874OtherGENERAL