Steven Jay Rodenburg, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D9744 Issued in MN

Practice address

8401 Seasons Pkwy
Woodbury, MN 55125-3414

Phone

(651) 738-2341

Fax

(651) 738-9048

NPI assigned

Nov 14, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 8, 2015 through Jan 8, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Oral Surgery Center

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Woodbury, MN
  • NPI 1104864529

  Oral and Maxillofacial Surgery

  NPD (past)
• Periodontal Center

  dba The Periodontal Center

  • Periodontics
  • Hudson, WI
  • NPI 1497348239
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457423519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 SEASONS PKWY",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253414",
            "telephone_number": "651-738-2341",
            "fax_number": "651-738-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 SEASONS PKWY",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253414",
            "telephone_number": "651-738-2341",
            "fax_number": "651-738-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODENBURG",
        "first_name": "STEVEN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "D9744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33797200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Traci Diane Robinson, RPH
• Heather Lynne Rocheford, M.D.
• Sara Rock, ATC
• Anthony Duane Rocke
• Erica Lynne Rodell Brown, PA-C
• Jenna Lynn Rodriguez Benke
• Amy Marie Leighia Rodriguez
• Maria Paula Rodriguez, AUD, CCC-A
• Nidia Maylen Rodriguez
• Sarah Roehrich, RN

• Oral and Maxillofacial Surgery (Dentist) in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.