Individual provider Active NPI

Jesus M Rodriguez, D.D.S.

  • General Practice Dentistry
  • Levelland, TX
National Provider Identifier
1689640443
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14983 Issued in TX
Practice address
901 12TH St
Levelland, TX 79336-5317
Phone
(806) 894-4499
Fax
(806) 894-9913
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 14983 TX Primary

Addresses

Primary practice location

901 12TH St
Levelland, TX 79336-5317

Mailing address

901 12TH St
Levelland, TX 79336-5317
Phone (806) 894-4499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160210001603 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7012141252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689640443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 12TH ST",
            "city": "LEVELLAND",
            "state": "TX",
            "postal_code": "793365317",
            "telephone_number": "806-894-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 12TH ST",
            "city": "LEVELLAND",
            "state": "TX",
            "postal_code": "793365317",
            "telephone_number": "806-894-4499",
            "fax_number": "806-894-9913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JESUS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "14983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Levelland, TX

Sources for this page

Verify at the official NPI Registry.