Ralph David Roden Jr., DMD, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5228 Issued in AL

Practice address

1771 Independence CT
Suite 2
Birmingham, AL 35216-1258

Phone

(205) 870-5834

Fax

(205) 870-1618

NPI assigned

May 21, 2007

Sex

Male

Sole proprietor

No

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

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1104035096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 INDEPENDENCE CT",
            "address_2": "SUITE 2",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352161258",
            "telephone_number": "205-870-5834",
            "fax_number": "205-870-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 INDEPENDENCE CT",
            "address_2": "SUITE 2",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352161258",
            "telephone_number": "205-870-5834",
            "fax_number": "205-870-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEN",
        "first_name": "RALPH",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AL",
            "license": "MD.28919",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AL",
            "license": "5228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Rocque
• Ryan Rebekah Roddy, M.D.
• Roden-Oms, LLC
• Christopher Dewayne Roden, CRNP
• Melissa T Roden, D.M.D.
• Rodgers Professional Services LLC
• Brian Scott Rodgers, LPC
• Grayson K Rodgers, M.D.
• Mackenzie Dreher Rodgers, M.D.
• Mary Rodgers, MD

• Oral and Maxillofacial Surgery (Dentist) in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.