Zachary Louis Rodriguez, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

30.024784 Issued in OH

Practice address

36050 Detroit Rd
T and U
Avon, OH 44011-1683

Phone

(510) 209-5896

NPI assigned

May 19, 2015

Last updated

Jan 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Zachary Louis Rodriguez Professional name

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1720467111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860036",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36050 DETROIT RD",
            "address_2": "T AND U",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440111683",
            "telephone_number": "510-209-5896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ZACHARY",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-19",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.024784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ZACHARY",
            "last_name": "RODRIGUEZ",
            "middle_name": "LOUIS",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• William S Richardson, MD
• Michelle R Riley, DO
• Cynthia Whipple Rimko, PT
• Morgan Rinas
• Angela Zubek Ristofski
• Kristen Roemer, LPN
• Carmen Rorapaugh, PA-C
• Brian Rose, RPH
• Chelsea M Rose, CCC-SLP
• Michael Rose, LPC

• Dentist in Avon, OH
• Providers in Avon, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.

Verify at the official NPI Registry.