Jose Carlos Rodriguez, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

001871 Issued in PR

Practice address

East Highway 18
Pine Ridge, SD 57770-1201

Phone

(605) 867-3078

Fax

(605) 867-3229

NPI assigned

Feb 7, 2006

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

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Pine Ridge Indian Health Service Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  TX

  Medicare reassignment NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Martin, SD
  • NPI 1003208257
  NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Wanblee, SD
  • NPI 1962559518
  NPD

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1467425926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6606 150TH LN",
            "city": "GORDON",
            "state": "NE",
            "postal_code": "693435407",
            "telephone_number": "308-282-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EAST HIGHWAY 18",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "577701201",
            "telephone_number": "605-867-3078",
            "fax_number": "605-867-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JOSE",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "001871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Ann Red Cloud McClung, R.N.
• Evelyn K Red Owl, R.N.
• Abigail Lynn Reed, RN
• Ronald A Reid, PHD
• Ken Riverson
• Jamie Louise Rodriquez, REGISTERED NURSE
• Sandra Kay Rooks, M.D.
• Sharla Laurene Roth, RPH
• Carmen A Ruiz, M.D.
• Robbie Anne Ryan, RN, BSN

• General Practice Dentistry in Pine Ridge, SD
• Providers in Pine Ridge, SD by specialty
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.