Dr. Roger William Roubal , DDS
Dentist - General Practice • Omaha, NE
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Roger Roubal has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Roger Roubal, DDS was a registered Dentist - General Practice practicing in Omaha, NE. Throughout an active medical career spanning 20 years, Dr. Roubal provided care at the practice location at 11919 GRANT ST until profile deactivation on 2026-03-16.
Historical Medicare Part B clinical services included x-ray of lower jaws, upper jaws and teeth, new patient outpatient office visit, established patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.
Practice Location & Contact Primary Location
11919 Grant St
Suite 140
Omaha, NE 681643475
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist - General Practice in Omaha, NE
Practicing in Omaha, NE (832 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Performed Procedures & Service Volume
Top Medicare Part B procedures performed by this practitioner
| HCPCS Code & Description | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
|
70355
X-ray of lower jaws, upper jaws and teeth
|
61 | 61 | $100.00 | $16.42 |
|
99204
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
|
58 | 58 | $550.00 | $149.38 |
|
99212
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
|
23 | 23 | $250.00 | $50.08 |
Medical Specialties & State Licenses
NUCC Taxonomy Code: 1223G0001X
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.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Dentist - General Practice
Doctor of Dental Surgery
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on March 16, 2026
NPI status registered as active in NPPES database
Registered at 11919 GRANT ST, SUITE 140, OMAHA, NE 681643475 (Tel: 4024934175)
Registered at 11919 GRANT ST, SUITE 140, OMAHA, NE 681643475 (Tel: 4024934175)
Recorded as ROGER ROUBAL, D.D.S.
Dentist (License #4339 in NE)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
11919 Grant St, Suite 140
Omaha, NE 681643475
Phone: 4024934175
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