Individual provider Active NPI

Eribel Rodriguez

  • Pediatric Dentistry
  • Brooklyn, NY
National Provider Identifier
1336724970
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
062715 Issued in NY
Practice address
2270 Kimball St Ste 202
Brooklyn, NY 11234-5159
Phone
(718) 253-0888
NPI assigned
Mar 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 062715 NY Primary

Addresses

Primary practice location

2270 Kimball St Ste 202
Brooklyn, NY 11234-5159

Mailing address

2270 Kimball St Ste 202
Brooklyn, NY 11234-5159
Phone (718) 253-0888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240912003866 NY Practitioner - Dentist 4880134147 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
062715NYMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Barnabas Hospital CurrentSince Aug 19, 2024 Accepting new patients
St. Barnabas Hospital Single Specialty CurrentSince Aug 19, 2024 Accepting new patients
Union Community Health Center, Inc. Single Specialty CurrentSince Aug 15, 2024 Accepting new patients
Big Little Smiles Pediatric Dentistry PLLC Pediatric Dentistry Past Accepting new patients

Locations

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

260 E 188th St
Bronx, NY 10458
Phone (718) 618-8236

2016 Bronxdale Ave
Ste 303
Bronx, NY 10462
Phone (718) 792-7972

2016 Bronxdale Ave
Bronx, NY 10462
Phone (718) 822-1515

Organizations & group practices 4

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": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1336724970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 KIMBALL ST STE 202",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345159",
            "telephone_number": "718-253-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 KIMBALL ST STE 202",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345159",
            "telephone_number": "718-253-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ERIBEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-15",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "062715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.