Individual provider Active NPI

Allan Rodrigues, DDS

  • Dentist
  • Orlando, FL
National Provider Identifier
1487262853
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN25237 Issued in FL
Practice address
1603 S Hiawassee Rd Ste 135
Orlando, FL 32835-6439
Phone
(407) 293-8324
NPI assigned
Jul 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN25237 FL Primary

Addresses

Primary practice location

1603 S Hiawassee Rd Ste 135
Orlando, FL 32835-6439

Mailing address

3585 Gretchen Dr
Ocoee, FL 34761-0029
Phone (321) 337-8008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200807000044 FL Order and Referring Only - DentistPractitioner - Dentist 0446675417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN25237FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. Dentist CurrentSince Jun 22, 2021 Accepting new patients
Coast Florida P.a. Dentist PastSince Aug 2, 2020 Accepting new patients

Locations

1603 S Hiawassee Rd
Ste 135
Orlando, FL 32835
Phone (407) 293-8324

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1487262853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 GRETCHEN DR",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347610029",
            "telephone_number": "321-337-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 S HIAWASSEE RD STE 135",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356439",
            "telephone_number": "407-293-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUES",
        "first_name": "ALLAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN25237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.