Individual provider Active NPI

Cristina A Rodriguez, DDS

  • General Practice Dentistry
  • Lynwood, CA
National Provider Identifier
1619001500
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
36509 Issued in CA
Practice address
3737 Martin Luther King Jr Blvd
Suite # 375
Lynwood, CA 90262-3513
Phone
(310) 639-9191
Fax
(310) 639-8179
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 36509 CA Primary

Addresses

Primary practice location

3737 Martin Luther King Jr Blvd
Suite # 375
Lynwood, CA 90262-3513

Mailing address

3737 Martin Luther King Jr Blvd
Suite # 375
Lynwood, CA 90262-3513
Phone (310) 639-9191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1619001500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE # 375",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623513",
            "telephone_number": "310-639-9191",
            "fax_number": "310-639-8179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE # 375",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623513",
            "telephone_number": "310-639-9191",
            "fax_number": "310-639-8179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CRISTINA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.