Active NPI
Noel Rodriguez, DMD
- Prosthodontics
- Jacksonville, FL
National Provider Identifier
1215390216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 25672
- Practice address
- Naval Branch Health Clinic Nas Jax
BLDG 9 64, Birmingham Ave.
Jacksonville, FL 32214-0001 - Phone
- (904) 546-7199
- NPI assigned
- Mar 29, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 25672 | TX | Primary |
Addresses
Primary practice location
Naval Branch Health Clinic Nas Jax
BLDG 9 64, Birmingham Ave.
Jacksonville, FL 32214-0001
Mailing address
Naval Branch Health Clinic Nas Jax
P.O. Box 8 BLDG 964
Jacksonville, FL 32214-0001
Phone (904) 546-7199
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 |
|---|---|---|---|
| 25672 | TX | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459209600000",
"number": "1215390216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NAVAL BRANCH HEALTH CLINIC NAS JAX",
"address_2": "P.O. BOX 8 BLDG 964",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322140001",
"telephone_number": "904-546-7199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NAVAL BRANCH HEALTH CLINIC NAS JAX",
"address_2": "BLDG 9 64, BIRMINGHAM AVE.",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322140001",
"telephone_number": "904-546-7199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "NOEL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-29",
"last_updated": "2016-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "TX",
"license": "25672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.