Individual provider Active NPI

Angelique L Rodgers, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Cumming, GA
National Provider Identifier
1245433408
Registry record updated Oct 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN010854 Issued in GA
Practice address
876 Buford Rd
Cumming, GA 30041-2716
Phone
(470) 990-8700
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DEN1000830 DC
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN010854 GA Primary

Addresses

Primary practice location

876 Buford Rd
Cumming, GA 30041-2716

Mailing address

4870 Collins Lake Dr
Mableton, GA 30126-1795
Phone (404) 394-5311

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
DEN1000830DCMDOrthodontics and Dentofacial Orthopedic Dentist
DN010854GAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667001600000",
    "number": "1245433408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4870 COLLINS LAKE DR",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301261795",
            "telephone_number": "404-394-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "876 BUFORD RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300412716",
            "telephone_number": "470-990-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "ANGELIQUE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2022-10-29",
        "certification_date": "2022-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "DC",
            "license": "DEN1000830",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN010854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2022; 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.