Individual provider Active NPI

Claudia Johana Rodriguez, DDS

  • Pediatric Dentistry
  • Hollywood, FL
National Provider Identifier
1700103686
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN18966 Issued in FL
Practice address
5000 Hollywood Blvd Ste 1
Hollywood, FL 33021-6530
Phone
(954) 989-4400
NPI assigned
Apr 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN18966 FL Primary

Addresses

Primary practice location

5000 Hollywood Blvd Ste 1
Hollywood, FL 33021-6530

Mailing address

19370 Collins Ave Apt 601
Sunny Isles Beach, FL 33160-2440
Phone (305) 798-6207

Other identifiers 1

IdentifierTypeStateIssuer
002509800MedicaidFL

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
DN18966FLMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine Pediatric Dentistry PA 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1700103686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19370 COLLINS AVE APT 601",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331602440",
            "telephone_number": "305-798-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 HOLLYWOOD BLVD STE 1",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216530",
            "telephone_number": "954-989-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CLAUDIA",
        "middle_name": "JOHANA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN18966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002509800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; 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.