Roanne Shoubaki
NPI 1053005504ActiveIndividual· Dentist, General Practice· Georgetown, TX
Dentist, General Practice in Georgetown, Texas, licensed in TX, with an NPI issued in June 2023. Enrolled in Medicare as practitioner - dentist.
Overview
| NPI | 1053005504 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Jun 7, 2023 |
| Last updated in NPPES | Jul 17, 2025 |
| Certified by provider | Jul 17, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 39434 | TX |
| Dentist | 122300000X | 39434 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Dentist (TX) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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