Active NPI
Joseph Paul Rodriguez, D.D.S.
- Dentist
- Chicago Heights, IL
National Provider Identifier
1255417010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.022809
- Practice address
- 171 W 10TH St
Suite 100
Chicago Heights, IL 60411-2072 - Phone
- (708) 503-5001
- Fax
- (708) 503-5008
- NPI assigned
- Oct 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019022809 | IL | |
| Dentist | 122300000X | 019.022809 | IL | Primary |
Addresses
Primary practice location
171 W 10TH St
Suite 100
Chicago Heights, IL 60411-2072
Mailing address
171 W 10TH St
Suite 100
Chicago Heights, IL 60411-2072
Phone (708) 503-5001
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019.022809 | IL | MD | Dentist |
| 019022809 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vincent R. Crescenzo, D.D.S., LTD. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Practice Dentistry
- Chicago Heights, IL
- NPI 1407290208
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366761600000",
"number": "1255417010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "171 W 10TH ST",
"address_2": "SUITE 100",
"city": "CHICAGO HEIGHTS",
"state": "IL",
"postal_code": "604112072",
"telephone_number": "708-503-5001",
"fax_number": "708-503-5008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 W 10TH ST",
"address_2": "SUITE 100",
"city": "CHICAGO HEIGHTS",
"state": "IL",
"postal_code": "604112072",
"telephone_number": "708-503-5001",
"fax_number": "708-503-5008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "JOSEPH",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-27",
"last_updated": "2013-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019022809",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.022809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.