Individual provider Active NPI

Odet Rodriguez, RDH

  • Dental Hygienist
  • La Quinta, CA
National Provider Identifier
1083098875
Registry record updated Jul 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
29053 Issued in CA
Practice address
51560 Avenida Velasco
La Quinta, CA 92253-3171
Phone
(760) 673-8259
NPI assigned
Jul 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 29053 CA Primary

Addresses

Primary practice location

51560 Avenida Velasco
La Quinta, CA 92253-3171

Mailing address

51560 Avenida Velasco
La Quinta, CA 92253-3171
Phone (760) 673-8259

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
29053CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1436659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436659200000",
    "number": "1083098875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51560 AVENIDA VELASCO",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922533171",
            "telephone_number": "760-673-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51560 AVENIDA VELASCO",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922533171",
            "telephone_number": "760-673-8259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ODET",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-12",
        "last_updated": "2015-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "29053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Quinta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2015; 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.