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Dr. Roger E Pradelli , DMD

Dentist - General Practice β€’ Keesler Afb, MS

Active NPI 1215929039 Individual Practitioner Male Practitioner
Practice location in NPPES

301 Fisher St
Keesler Afb, MS 395342508

Call 2283760512 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

301 Fisher St

Keesler Afb, MS 395342508

Telephone 2283760512
Organization at the Same NPPES Address or Phone
81st Medgrp-Keesler Facility NPI 1710967526

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2005

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Keesler Afb and Mississippi

7 active clinicians are listed under Dentist - General Practice with a practice address in Keesler Afb, MS (845 in Mississippi).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

License # reported to NPPES DE 0001101

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Mississippi State Medical Licensing Board.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

33 listed
Dr. Matthew Barchie , MD

Radiology - Diagnostic Radiology

NPI 1952518235

Doctor of Medicine (M.D.)

Dr. Jared Bell , MD

Orthopaedic Surgery

NPI 1467987545

Doctor of Medicine (M.D.)

NPI 1609831650

Doctor of Medicine (M.D.)

Dr. Jennifer Eaglebarger , DNP, FNP-C

Nurse Practitioner - Family

NPI 1952866295

Doctor of Nursing Practice, Family Nurse Practitioner (Certified)

Dr. Fernando Ferrera , MD

Orthopaedic Surgery

NPI 1124640420

Doctor of Medicine (M.D.)

Dr. Britain Gailliot , MD

Radiology - Diagnostic Radiology

NPI 1821401159

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location April 26, 2018

Registered at 301 FISHER ST, KEESLER AFB, MS 395342508 (Tel: 2283760512)

πŸ“
Updated Business Mailing Address April 26, 2018

Registered at 301 FISHER ST, KEESLER AFB, MS 395342508 (Tel: 2283760512)

βœ…
NPI Profile Active September 04, 2008

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 04, 2008

Registered at 7219 N LITCHFIELD RD, LUKE AFB, AZ 853091529 (Tel: 6238569045)

πŸ“
Business Mailing Address (Initial Record) September 04, 2008

Registered at 3014 N MEADOW LN, AVONDALE, AZ 853234329 (Tel: 2103831588)

πŸ‘€
Provider Name / Credentials (Initial Record) September 04, 2008

Recorded as ROGER PRADELLI, DMD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 04, 2008

Dentist (license number reported to NPPES: DE 0001101)

🟒
Initial NPI Registration & Enumeration August 17, 2005

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1215929039
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 17, 2005
Last Update: April 26, 2018
Sole Proprietor: No

Mailing Address

301 Fisher St

Keesler Afb, MS 395342508

Phone: 2283760512

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.