Otto J Rodriguez, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401416192 Issued in VA

Practice address

651 W 171St St Apt 27
New York, NY 10032-3025

Phone

(917) 678-6200

NPI assigned

Jul 19, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

State licenses

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1154807451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 W 171ST ST APT 27",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323025",
            "telephone_number": "917-678-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 W 171ST ST APT 27",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323025",
            "telephone_number": "917-678-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "OTTO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-19",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401416192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Alexis Rodriguez, FNP-BC
• Noah Gabriel Rodriguez, MD
• Noelani Rodriguez, LCAT
• Olga Rodriguez, BPS
• Oscar David Rodriguez, M.D.
• Paul Vincent Ongsueco Rodriguez, PHARM.D.
• Pauline Rodriguez, CASAC
• Quilvio Antonio Rodriguez, PMHNP-BC, RN
• Rafaelina Rodriguez
• Raquel Rodriguez

• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.