Individual provider Active NPI

Katherine Rodriguez, D.M.D.

  • Periodontics
  • Miami, FL
National Provider Identifier
1104086354
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
3523 Issued in PR
Practice address
1330 Coral Way Ste 100
Miami, FL 33145-2929
Phone
(305) 285-5150
NPI assigned
Jun 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DN16597 FL
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 3523 PR Primary

Addresses

Primary practice location

1330 Coral Way Ste 100
Miami, FL 33145-2929

Mailing address

G14 Ave Las Palomas
San Juan, PR 00926-6516
Phone (305) 479-5800

Other practice location 1

1738 Calle Amarillo Ste 207A
San Juan, PR 00926-3072
Phone (787) 281-0614

Other practice location 2

15805 Biscayne Blvd Ste 202
Aventura, FL 33160-5377
Phone (305) 652-2255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150225001317 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6305162991

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3523PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bosque DDS LLC Past Accepting new patients

Organizations & group practices 1

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": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1104086354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "G14 AVE LAS PALOMAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266516",
            "telephone_number": "305-479-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 CORAL WAY STE 100",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331452929",
            "telephone_number": "305-285-5150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1738 Calle Amarillo Ste 207A",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "009263072",
            "country_code": "US",
            "telephone_number": "787-281-0614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15805 Biscayne Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Aventura",
            "state": "FL",
            "postal_code": "331605377",
            "country_code": "US",
            "telephone_number": "305-652-2255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN16597",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "PR",
            "license": "3523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.