Individual provider Active NPI

Carla Julianne Leon-Rodriguez, DMD

  • General Practice Dentistry
  • University Park, FL
National Provider Identifier
1205394376
Registry record updated Apr 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN25778 Issued in FL
Practice address
5231 University Pkwy Unit 120
University Park, FL 34201-3009
Phone
(941) 363-0458
NPI assigned
Mar 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X DN25778 FL Primary

Addresses

Primary practice location

5231 University Pkwy Unit 120
University Park, FL 34201-3009

Mailing address

5231 University Pkwy Unit 120
University Park, FL 34201-3009
Phone (941) 363-0458

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

LicenseStateTypeSpecialty
DN25778FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dixon Dental Concepts Inc PastSince Jul 17, 2021 Accepting new patients

Networks

  • Freedom Health HMO Network

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": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745625600000",
    "number": "1205394376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5231 UNIVERSITY PKWY UNIT 120",
            "city": "UNIVERSITY PARK",
            "state": "FL",
            "postal_code": "342013009",
            "telephone_number": "941-363-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5231 UNIVERSITY PKWY UNIT 120",
            "city": "UNIVERSITY PARK",
            "state": "FL",
            "postal_code": "342013009",
            "telephone_number": "941-363-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON-RODRIGUEZ",
        "first_name": "CARLA",
        "middle_name": "JULIANNE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2025-04-26",
        "certification_date": "2025-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN25778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2025; 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.