Individual provider Active NPI

Hevony Rodriguez, DDS

  • Dentist
  • San Antonio, TX
National Provider Identifier
1093327108
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36595 Issued in TX
Practice address
1102 Barclay St
San Antonio, TX 78207-7161
Phone
(210) 233-7000
Fax
(210) 432-2645
NPI assigned
Aug 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 36595 TX
Dentist 122300000X 36595 TX Primary

Addresses

Primary practice location

1102 Barclay St
San Antonio, TX 78207-7161

Mailing address

1214 Taubenfeld
San Antonio, TX 78260-4458
Phone (956) 285-7129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241106000790 TX Practitioner - Dentist 6709206220 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36595TXMDPublic Health Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Oct 25, 2024 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Oct 25, 2024 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. Current Accepting new patients

Locations

1102 Barclay St
San Antonio, TX 78207
Phone (210) 434-0513

3066 E Commerce St
San Antonio, TX 78220
Phone (210) 233-7062

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1093327108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 TAUBENFELD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782604458",
            "telephone_number": "956-285-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 BARCLAY ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782077161",
            "telephone_number": "210-233-7000",
            "fax_number": "210-432-2645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "HEVONY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "TX",
            "license": "36595",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "36595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.