Active NPI
Destini Faith Rodriguez, DDS
- General Practice Dentistry
- Fort Worth, TX
National Provider Identifier
1124758800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 38602
- Practice address
- 7355 N Beach St Ste 133
Fort Worth, TX 76137-1898 - Phone
- (817) 935-8686
- NPI assigned
- Jun 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 38602 | TX | Primary |
Addresses
Primary practice location
7355 N Beach St Ste 133
Fort Worth, TX 76137-1898
Mailing address
631 Meadowbrooke PL
Duncanville, TX 75137-3821
Phone (214) 543-9577
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
| License | State | Type | Specialty |
|---|---|---|---|
| 38602 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655164800000",
"number": "1124758800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "631 MEADOWBROOKE PL",
"city": "DUNCANVILLE",
"state": "TX",
"postal_code": "751373821",
"telephone_number": "214-543-9577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7355 N BEACH ST STE 133",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761371898",
"telephone_number": "817-935-8686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "DESTINI",
"middle_name": "FAITH",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-14",
"last_updated": "2022-06-14",
"certification_date": "2022-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "38602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.