Individual provider Active NPI

Maira Rodriguez, DDS

  • General Practice Dentistry
  • Taylor, MI
National Provider Identifier
1265646129
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901018189 Issued in MI
Practice address
24929 Goddard Rd
Taylor, MI 48180-3930
Phone
(734) 947-3621
Fax
(734) 947-3633
NPI assigned
May 10, 2007
Sex
Female
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901018189 MI Primary

Addresses

Primary practice location

24929 Goddard Rd
Taylor, MI 48180-3930

Mailing address

1888 Prairie Dunes CT S
Ann Arbor, MI 48108-8641
Phone (734) 255-1839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20161121000783 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5294014957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas N. Dupuis DDS PC General Practice Past Accepting new patients
Maira M Rodriguez DMD PC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265646129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1888 PRAIRIE DUNES CT S",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481088641",
            "telephone_number": "734-255-1839",
            "fax_number": "734-947-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24929 GODDARD RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481803930",
            "telephone_number": "734-947-3621",
            "fax_number": "734-947-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MAIRA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

Verify at the official NPI Registry.