Active NPI
Christopher Michael Rodriguez, DDS
- General Practice Dentistry
- Springdale, AR
National Provider Identifier
1013366434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4098
- Practice address
- 1521 Executive PL Ste a
Springdale, AR 72762-4260 - Phone
- (479) 250-1516
- Fax
- (479) 225-9220
- NPI assigned
- Jun 7, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4098 | AR | Primary |
Addresses
Primary practice location
1521 Executive PL Ste a
Springdale, AR 72762-4260
Mailing address
1521 Executive PL Ste a
Springdale, AR 72762-4260
Phone (479) 250-1516
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4098 | AR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rodriguez Dentistry PLLC | General Practice | Current | Accepting new patients |
Locations
1521 Executive Pl
Ste A
Springdale, AR 72762
Phone (479) 250-1516
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600646400000",
"number": "1013366434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1521 EXECUTIVE PL STE A",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727624260",
"telephone_number": "479-250-1516",
"fax_number": "479-225-9220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1521 EXECUTIVE PL STE A",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727624260",
"telephone_number": "479-250-1516",
"fax_number": "479-225-9220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "CHRISTOPHER",
"middle_name": "MICHAEL",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-07",
"last_updated": "2020-09-21",
"certification_date": "2020-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "4098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.