Individual provider Active NPI

Martha Juliana Rodriguez Boada, DMD

  • Dentist
  • Woodbridge, VA
National Provider Identifier
1508561317
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401419084 Issued in VA
Practice address
3350 Commission CT
Woodbridge, VA 22192-1784
Phone
(703) 680-7950
NPI assigned
Apr 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH26428 FL
Dental Hygienist 124Q00000X HYG1001025 DC
Dentist 122300000X 0401419084 VA Primary

Addresses

Primary practice location

3350 Commission CT
Woodbridge, VA 22192-1784

Mailing address

4509 Whittemore PL
Fairfax, VA 22030-6270
Phone (407) 617-4582

Other practice location 1

10 Center Drive Nihbc 10 - Crc Bg Rm 1-5673
Bethesda, MD 20892-0001
Phone (407) 617-4582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250102002692 PA Order and Referring Only - DentistPractitioner - Dentist 4981131935

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
HYG1001025DCMDDental Hygienist
DH26428FLMDDental Hygienist

Interoperability endpoints

  • Direct secure messaging: martha.rodriguez@gpwchc.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1508561317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4509 WHITTEMORE PL",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306270",
            "telephone_number": "407-617-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 COMMISSION CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221921784",
            "telephone_number": "703-680-7950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Center Drive Nihbc 10 - Crc Bg Rm 1-5673",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208920001",
            "country_code": "US",
            "telephone_number": "407-617-4582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ BOADA",
        "first_name": "MARTHA",
        "middle_name": "JULIANA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "FL",
            "license": "DH26428",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "DC",
            "license": "HYG1001025",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401419084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.