William C Roddy, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D17765 Issued in TX

Practice address

1219 6TH Ave
Fort Worth, TX 76104-4308

Phone

(817) 336-0212

Fax

(817) 810-0462

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235248055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 6TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044308",
            "telephone_number": "817-336-0212",
            "fax_number": "817-810-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 6TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044308",
            "telephone_number": "817-336-0212",
            "fax_number": "817-810-0462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODDY",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "D17765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "D17765",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "977036",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Austin A Rock, RPH
• Rockwall Investors Limited, LLC
• Leteshia Rockwell, LCSW
• Rockwood Medical Clinic, P.a.
• Rockwood Wellness Clinic LLC
• Lauren Rodell, NP
• Ryan Rodems, ATC
• Rodeo Dental Main Street, PLLC
• Rodeo Edinburg & Orthodontics, PLLC
• Austin Dwight Rodgers

• General Practice Dentistry in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.