Isa Rodriguez

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.027264 Issued in OH

Practice address

6160 Gender Rd
Canal Winchester, OH 43110-2054

Phone

(614) 688-3763

NPI assigned

Mar 6, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Magnolia Canal Winchester LLC

  • General Practice Dentistry
  • Canal Winchester, OH
  • NPI 1649883018
  NPD

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1245930544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 GENDER RD",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431102054",
            "telephone_number": "614-591-3522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 GENDER RD",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431102054",
            "telephone_number": "614-688-3763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.027264",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.027264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Ritchey, P.T.
• Katie Ellen Rizco, CCC-SLP
• Lakeima Roberts
• Kimberly Lavette Robinson-Herriott
• Melissa Rockwell, RN
• Elizabeth Jane Samuelson, DPT
• Isatu Samura
• Sanctuary House of Recovery, LLC
• Saroj Sapkota
• Cheryl Lynn Saunders

• General Practice Dentistry in Canal Winchester, OH
• Providers in Canal Winchester, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.