Active NPI
Joseph Rodriguez, DMD
- General Practice Dentistry
- Myrtle Beach, SC
National Provider Identifier
1659723898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DGD11379
- 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, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161219002085 | FL | Order and Referring Only - Dentist | 6800177411 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN22083 | FL | MD | General Practice Dentistry |
| DGD11379 | SC | MD | General Practice Dentistry |
| DGD11381 | SC | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Flossy Orthodontics LLC | Orthodontics and Dentofacial Orthopedics | Past | 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.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Myrtle Beach, SC
- NPI 1780559989
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.