DR. CHARLES E JR. CONKLIN (DDS) – Oral and Maxillofacial Surgery (Dentist), NPI 1366410839

DR. CHARLES E JR. CONKLIN (DDS) is a healthcare provider. based in Roanoke, Virginia. specializing in Oral and Maxillofacial Surgery (Dentist). They hold the professional credentials DDS. They hold a License No. 0401-004990 (VA). The NPI Number for DR. CHARLES E JR. CONKLIN (DDS) is 1366410839

Main info

Male
Name
DR. CHARLES E JR. CONKLIN (DDS)
NPI
1366410839
Phone
Not provided
Address
4569 KEAGY RD
Enumeration Date
10 March 2006
Last Update Date
30 April 2008
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. CHARLES E JR. CONKLIN (DDS)

  • Keagy Road, Southdowns, Cave Spring, Roanoke County, Virginia, 24018, United States

    ROANOKE, VA 240187417

    Phone:

    Type: Mailing

  • Jefferson Street, Roanoke Rapids, Halifax County, North Carolina, 27870, United States

    CARILION DENTAL CLINIC

    ROANOKE, VA 240142419

    Phone: (540) 981-7128

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-03-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110303000314IOral SurgeryVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 24018)

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Reviews

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Frequently asked questions

What is DR. CHARLES E JR. CONKLIN (DDS)'s NPI number?
DR. CHARLES E JR. CONKLIN (DDS)'s NPI is 1366410839 — the number used across U.S. healthcare to identify this provider.
Would DR. CHARLES E JR. CONKLIN (DDS) appear as active to a payer?
You can treat DR. CHARLES E JR. CONKLIN (DDS) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with DR. CHARLES E JR. CONKLIN (DDS)?
DR. CHARLES E JR. CONKLIN (DDS)'s record emphasizes Oral and Maxillofacial Surgery (Dentist). Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. CHARLES E JR. CONKLIN (DDS)?
Travel planning: use Roanoke, Virginia as the reference point for DR. CHARLES E JR. CONKLIN (DDS), then confirm.
When was this NPI issued?
Enumeration for DR. CHARLES E JR. CONKLIN (DDS) is noted as March 10, 2006 where the registry provides it.

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