Individual provider Active NPI

Rodlin Jerome, D.D.S

  • General Practice Dentistry
  • Miami Shores, FL
National Provider Identifier
1124398813
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19632 Issued in FL
Practice address
10728 NW 2ND Ave
Miami Shores, FL 33168-4301
Phone
(786) 285-5257
NPI assigned
Jan 11, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19632 FL Primary

Addresses

Primary practice location

10728 NW 2ND Ave
Miami Shores, FL 33168-4301

Mailing address

10728 NW 2ND Ave
Miami Shores, FL 33168-4301
Phone (786) 285-5257

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
19632FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1124398813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10728 NW 2ND AVE",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331684301",
            "telephone_number": "786-285-5257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10728 NW 2ND AVE",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331684301",
            "telephone_number": "786-285-5257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEROME",
        "first_name": "RODLIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "19632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Shores, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.