Individual provider Active NPI

Roxanna Delgado-Rodriguez

  • General Practice Dentistry
  • Skokie, IL
National Provider Identifier
1740639095
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3242 Issued in PR
Practice address
5225 Touhy Ave
Skokie, IL 60077-3245
Phone
(847) 807-7341
NPI assigned
Jun 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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 3242 PR Primary

Addresses

Primary practice location

5225 Touhy Ave
Skokie, IL 60077-3245

Mailing address

1177 Calle Verona
San Juan, PR 00924-4060
Phone (787) 342-9049

Other practice location 1

105 Oxford Exchange Blvd
Oxford, AL 36203-3448
Phone (256) 676-2055

Other practice location 2

1177 Calle Verona
San Juan, PR 00924
Phone (787) 342-9049

Other identifiers 1

IdentifierTypeStateIssuer
6232756OtherPRDRIVERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20180329001355 PR Order and Referring Only - DentistPractitioner - Dentist 2668734716

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3242PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mena Dental PLLC General Practice CurrentSince Apr 20, 2025 Accepting new patients
Mithila Sharma DDS PLLC General Practice CurrentSince Nov 9, 2021 Accepting new patients
Gillespie Dental LLC General Practice PastSince Dec 22, 2020 Accepting new patients

Locations

5225 Touhy Ave
Skokie, IL 60077
Phone (847) 521-6676

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1740639095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 CALLE VERONA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009244060",
            "telephone_number": "787-342-9049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 TOUHY AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773245",
            "telephone_number": "847-807-7341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Oxford Exchange Blvd",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "AL",
            "postal_code": "362033448",
            "country_code": "US",
            "telephone_number": "256-676-2055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1177 Calle Verona",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "00924",
            "country_code": "US",
            "telephone_number": "787-342-9049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELGADO-RODRIGUEZ",
        "first_name": "ROXANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "3242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS",
            "identifier": "6232756",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.