Individual provider Active NPI

Patricia Rodriguez

  • Dentist
  • Charlotte, NC
National Provider Identifier
1225684699
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14089 Issued in NC
Practice address
9380 Sullivan Vale LN Ste a
Charlotte, NC 28215-7076
Phone
(704) 954-8548
NPI assigned
Aug 12, 2019
Last updated
May 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN24428 FL
Dentist 122300000X 14089 NC Primary

Addresses

Primary practice location

9380 Sullivan Vale LN Ste a
Charlotte, NC 28215-7076

Mailing address

19407 Booth Bay CT
Cornelius, NC 28031-3705
Phone (954) 740-9485

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
DN24428FLMDDentist
14089NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
K. Jasinski, D.M.D., P.C. CurrentSince May 18, 2025 Accepting new patients

Locations

9380 Sullivan Vale Ln
Ste A
Charlotte, NC 28215
Phone (704) 954-8548

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1225684699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19407 BOOTH BAY CT",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280313705",
            "telephone_number": "954-740-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9380 SULLIVAN VALE LN STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282157076",
            "telephone_number": "704-954-8548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "PATRICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24428",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "14089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.