Individual provider Active NPI

Joseph Rodriguez, DMD

  • General Practice Dentistry
  • Myrtle Beach, SC
National Provider Identifier
1659723898
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DGD11379 Issued in SC
Practice address
5004 Carolina Forest Blvd
Myrtle Beach, SC 29579-3579
Phone
(843) 380-9080
Fax
(843) 380-9081
NPI assigned
Jul 12, 2016
Last updated
May 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DGD11379 SC Primary
General Practice Dentistry 1223G0001X DN22083 FL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DGD11381 SC

Addresses

Primary practice location

5004 Carolina Forest Blvd
Myrtle Beach, SC 29579-3579

Mailing address

5004 Carolina Forest Blvd
Myrtle Beach, SC 29579-3579
Phone (843) 380-9080

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
I20161219002085 FL Order and Referring Only - DentistPractitioner - Dentist 6800177411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN22083FLMDGeneral Practice Dentistry
DGD11379SCMDGeneral Practice Dentistry
DGD11381SCMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Flossy Orthodontics LLC Orthodontics and Dentofacial Orthopedics PastSince Oct 12, 2025 Accepting new patients

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, 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": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1659723898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5004 CAROLINA FOREST BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793579",
            "telephone_number": "843-380-9080",
            "fax_number": "843-380-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5004 CAROLINA FOREST BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793579",
            "telephone_number": "843-380-9080",
            "fax_number": "843-380-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-12",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD11379",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN22083",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "SC",
            "license": "DGD11381",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.