Individual provider Active NPI

Victor E. Rodman, DDS

  • Pediatric Dentistry
  • Gladstone, MO
National Provider Identifier
1396739652
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
010601 Issued in MO
Practice address
231 NW 72ND St
Gladstone, MO 64118-1821
Phone
(816) 436-5900
NPI assigned
Sep 1, 2005
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
Pediatric Dentistry 1223P0221X 010601 MO Primary

Addresses

Primary practice location

231 NW 72ND St
Gladstone, MO 64118-1821

Mailing address

231 NW 72ND St
Gladstone, MO 64118-1821
Phone (816) 436-7103

Other identifiers 1

IdentifierTypeStateIssuer
05705013OtherMOBLUE CROSS BLUE SHIELD

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

LicenseStateTypeSpecialty
010601MOMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396739652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 NW 72ND ST",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641181821",
            "telephone_number": "816-436-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 NW 72ND ST",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641181821",
            "telephone_number": "816-436-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODMAN",
        "first_name": "VICTOR",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "010601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "05705013",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladstone, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.