Individual provider Active NPI

Edwin Daniel Rodriguez-Rios, D.M.D

  • Prosthodontics
  • Mayaguez, PR
National Provider Identifier
1174762777
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
2801 Issued in PR
Practice address
45 Calle Andalucia
Ste. 201
Mayaguez, PR 00680-8201
Phone
(787) 265-5701
Fax
(787) 256-5794
NPI assigned
Feb 5, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 2801 PR Primary
Dentist 122300000X 2801 PR

Addresses

Primary practice location

45 Calle Andalucia
Ste. 201
Mayaguez, PR 00680-8201

Mailing address

45 Calle Andalucia
Ste. 201
Mayaguez, PR 00680-8201
Phone (787) 265-5701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20160617001260 PR Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6800187089

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2801PRMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Health Dentistry PSC Dentist 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": "1233792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1174762777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CALLE ANDALUCIA",
            "address_2": "STE. 201",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006808201",
            "telephone_number": "787-265-5701",
            "fax_number": "787-256-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CALLE ANDALUCIA",
            "address_2": "STE. 201",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006808201",
            "telephone_number": "787-265-5701",
            "fax_number": "787-256-5794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-RIOS",
        "first_name": "EDWIN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-05",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "PR",
            "license": "2801",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "2801",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.