MEDICARE: DAVID ROACH DDS FAMILY DENTISTRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1093644528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID ROACH DDS FAMILY DENTISTRY

Provider Business Mailing Address
First Line	:	3824 BEDFORD AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215
Country	:	US
Telephone Number	:	615-383-7801
Fax Number	:	615-297-2834

Provider Business Practice Location Address
First Line	:	3824 BEDFORD AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215
Country	:	US
Telephone Number	:	615-383-7801
Fax Number	:	615-297-2834

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	DR. CHARLES DAVID ROACH
Credential	:	DDS
Telephone Number	:	615-479-4686

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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