Individual provider Active NPI

Lester Manuel Rodriguez, DDS

  • Dentist
  • Daytona Beach, FL
National Provider Identifier
1063583292
Registry record updated Jan 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
31246 Issued in FL
Practice address
1845 Holsonback Dr
Daytona Beach, FL 32117-5282
Phone
(386) 274-0500
NPI assigned
Nov 10, 2006
Last updated
Jan 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 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 31246 FL Primary
General Practice Dentistry 1223G0001X 49650 CA

Addresses

Primary practice location

1845 Holsonback Dr
Daytona Beach, FL 32117-5282

Mailing address

1016 S Palmetto Ave
Daytona Beach, FL 32114-6164
Phone (626) 975-2743

Other practice location 1

546 W Badillo St
Covina, CA 91722-3762
Phone (626) 331-6666

Other practice location 2

1016 S Palmetto Ave
Daytona Beach, FL 32114-6164
Phone (626) 975-2743

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
49650CAMDMarriage & Family Therapist
31246FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Mar 20, 2025 Accepting new patients
Florida Department of Health PastSince Mar 20, 2025 Accepting new patients

Locations

1845 Holsonback Dr
Daytona Beach, FL 32117
Phone (386) 274-0500

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769817600000",
    "number": "1063583292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 S PALMETTO AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321146164",
            "telephone_number": "626-975-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 HOLSONBACK DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175282",
            "telephone_number": "386-274-0500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "546 W Badillo St",
            "address_purpose": "LOCATION",
            "city": "Covina",
            "state": "CA",
            "postal_code": "917223762",
            "country_code": "US",
            "telephone_number": "626-331-6666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1016 S Palmetto Ave",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321146164",
            "country_code": "US",
            "telephone_number": "626-975-2743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LESTER",
        "middle_name": "MANUEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2026-01-31",
        "certification_date": "2026-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "31246",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49650",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.