Individual provider Active NPI

Narda Rodriguez, D.M.D

  • General Practice Dentistry
  • Aliso Viejo, CA
National Provider Identifier
1548570831
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61306 Issued in CA
Practice address
29 Michelangelo
Aliso Viejo, CA 92656-1476
Phone
(305) 336-6475
NPI assigned
Oct 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 61306 CA Primary

Addresses

Primary practice location

29 Michelangelo
Aliso Viejo, CA 92656-1476

Mailing address

29 Michelangelo
Aliso Viejo, CA 92656-1476
Phone (305) 336-6475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160906001799 FL Order and Referring Only - DentistPractitioner - Dentist 1850687526
I20241212001721 CA Order and Referring Only - DentistPractitioner - Dentist 1850687526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61306CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Narda Rodriguez DMD Inc CurrentSince Aug 18, 2019 Accepting new patients

Locations

20671 Lake Forest Dr
Ste B103
Lake Forest, CA 92630
Phone (305) 336-6475

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1548570831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 MICHELANGELO",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926561476",
            "telephone_number": "305-336-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 MICHELANGELO",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926561476",
            "telephone_number": "305-336-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "NARDA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aliso Viejo, CA

Sources for this page

Verify at the official NPI Registry.