Individual provider Active NPI

Andrea S Rodriguez Rolon, DMD

  • Pediatric Dentistry
  • Ponce, PR
National Provider Identifier
1043052061
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
3564 Issued in PR
Practice address
1123 Avenida Hostos
Edificio Go Gogo Foundation
Ponce, PR 00780
Phone
(939) 422-2142
NPI assigned
Jun 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3564 PR
Pediatric Dentistry 1223P0221X 3564 PR Primary

Addresses

Primary practice location

1123 Avenida Hostos
Edificio Go Gogo Foundation
Ponce, PR 00780

Mailing address

305 Calle 20
Guaynabo, PR 00969-4451
Phone (787) 466-7289

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1043052061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 CALLE 20",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009694451",
            "telephone_number": "787-466-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 AVENIDA HOSTOS",
            "address_2": "EDIFICIO GO GOGO FOUNDATION",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00780",
            "telephone_number": "939-422-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ ROLON",
        "first_name": "ANDREA",
        "middle_name": "S",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "3564",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PR",
            "license": "3564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.