Individual provider Active NPI

David H. Rhoden III, DDS

  • Dentist
  • Waco, TX
National Provider Identifier
1245363167
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9741 Issued in TX
Practice address
2098 N Valley Mills Dr
Ste. B
Waco, TX 76710-2586
Phone
(254) 399-0390
Fax
(254) 399-9854
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9741 TX Primary
Dentist 122300000X 1128 AK

Addresses

Primary practice location

2098 N Valley Mills Dr
Ste. B
Waco, TX 76710-2586

Mailing address

2098 N Valley Mills Dr
Ste. B
Waco, TX 76710-2586
Phone (254) 399-0390

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160614000264 TX Order and Referring Only - DentistPractitioner - Dentist 2567753080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9741TXMDAddiction (Substance Use Disorder) Counselor
1128AKMDObstetrics & Gynecology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245363167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2098 N VALLEY MILLS DR",
            "address_2": "STE. B",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102586",
            "telephone_number": "254-399-0390",
            "fax_number": "254-399-9854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2098 N VALLEY MILLS DR",
            "address_2": "STE. B",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102586",
            "telephone_number": "254-399-0390",
            "fax_number": "254-399-9854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHODEN",
        "first_name": "DAVID",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "9741",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "1128",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.