Individual provider Active NPI

Rodolfo Francisco Rodriguez Noalla, DMD

  • Dentist
  • Seattle, WA
National Provider Identifier
1043887201
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE61180844 Issued in WA
Practice address
1732 Broadway Unit 402
Seattle, WA 98122-2414
Phone
(395) 335-6406
NPI assigned
Jun 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE61180844 WA Primary

Addresses

Primary practice location

1732 Broadway Unit 402
Seattle, WA 98122-2414

Mailing address

1732 Broadway Unit 402
Seattle, WA 98122-2414
Phone (395) 335-6406

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

LicenseStateTypeSpecialty
DE61180844WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1043887201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 BROADWAY UNIT 402",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222414",
            "telephone_number": "395-335-6406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 BROADWAY UNIT 402",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222414",
            "telephone_number": "395-335-6406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ NOALLA",
        "first_name": "RODOLFO",
        "middle_name": "FRANCISCO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61180844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.