Individual provider Active NPI

Victor Rodriguez, DDS, CAGS

  • Dentist
  • Doral, FL
National Provider Identifier
1699194092
Registry record updated Mar 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN21843 Issued in FL
Practice address
2000 NW 87TH Ave Ste 215
Doral, FL 33172-2657
Phone
(786) 953-6550
Fax
(786) 431-5918
NPI assigned
Apr 14, 2014
Last updated
Mar 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X DN21843 FL
Dentist 122300000X DN21843 FL Primary

Addresses

Primary practice location

2000 NW 87TH Ave Ste 215
Doral, FL 33172-2657

Mailing address

2000 NW 87TH Ave Ste 215
Doral, FL 33172-2657
Phone (786) 953-6550

Other practice location 1

7900 NW 27th Ave Ste 275
Miami, FL 33147-4909
Phone (305) 693-7988

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

State licenses

LicenseStateTypeSpecialty
DN21843FLMDMulti-Specialty Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Luvic Advanced Dentistry Current Accepting new patients
Luvic Advanced Dentistry Aventura Inc Current Accepting new patients
Professional Dental Solutions, Inc Dentist PastSince Jun 12, 2018 Accepting new patients

Locations

2000 NW 87th Ave
Ste 215
Doral, FL 33172
Phone (786) 953-6550

2627 NE 203rd St
Ste 212
Miami, FL 33180
Phone (305) 932-9202

Organizations & group practices 3

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": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1699194092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 NW 87TH AVE STE 215",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722657",
            "telephone_number": "786-953-6550",
            "fax_number": "786-431-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NW 87TH AVE STE 215",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722657",
            "telephone_number": "786-953-6550",
            "fax_number": "786-431-5918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7900 NW 27th Ave Ste 275",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331474909",
            "country_code": "US",
            "telephone_number": "305-693-7988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "VICTOR",
        "credential": "DDS, CAGS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-14",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "FL",
            "license": "DN21843",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; 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.