Individual provider Active NPI

Roberto Jose Rodil, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Ponce, PR
National Provider Identifier
1366418402
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
2457 Issued in PR
Practice address
8118 Calle Concordia
Galeria Profesional Suite 204
Ponce, PR 00717-1562
Phone
(787) 840-0881
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2457 PR Primary

Addresses

Primary practice location

8118 Calle Concordia
Galeria Profesional Suite 204
Ponce, PR 00717-1562

Mailing address

8118 Calle Concordia
Galeria Profesional Suite 204
Ponce, PR 00717-1562
Phone (787) 840-0881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20241028003930 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5193258291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2457PRMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366418402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8118 CALLE CONCORDIA",
            "address_2": "GALERIA PROFESIONAL SUITE 204",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171562",
            "telephone_number": "787-840-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8118 CALLE CONCORDIA",
            "address_2": "GALERIA PROFESIONAL SUITE 204",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171562",
            "telephone_number": "787-840-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODIL",
        "first_name": "ROBERTO",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2026-07-13",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PR",
            "license": "2457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.