Luis Mauricio Rodriguez, D.D.S, P.A.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

29164 Issued in TX

Practice address

11 Professional Park Drive
Webster, TX 77598

Phone

(281) 317-6401

Fax

(281) 488-2888

NPI assigned

Jun 25, 2013

Last updated

Dec 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 5, 2016 through Feb 5, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• L. Mauricio Rodriguez DDS, PA

  dba Premier Dental

  • General Practice Dentistry
  • Webster, TX
  • NPI 1881063816
  NPD Authorized official

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1043659972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PROFESSIONAL PARK DRIVE",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "77598",
            "telephone_number": "281-317-6401",
            "fax_number": "281-488-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 PROFESSIONAL PARK DRIVE",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "77598",
            "telephone_number": "281-317-6401",
            "fax_number": "281-488-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LUIS",
        "middle_name": "MAURICIO",
        "name_prefix": "Mr.",
        "credential": "D.D.S, P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29164",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "29164",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Ann Robinson, M.D.
• Michael Keith Rock, PHD PT
• Alan Joseph Rodney, MD
• Deanna Rodriguez
• Heather Rodriguez, SLP-ASSISTANT
• Maria Elena Rodriguez, PTA
• Sabrina Ann Rodriguez
• Saul Rodriguez
• Kendall Renee Roehl, MD
• Jennifer Lee Rollins, M.S., C.G.C.

• General Practice Dentistry in Webster, TX
• Providers in Webster, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.