Individual provider Active NPI

Jorge Alejandro Rodriguez, DDS

  • General Practice Dentistry
  • River Ridge, LA
National Provider Identifier
1750121810
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7564 Issued in LA
Practice address
9541 Jefferson Hwy
River Ridge, LA 70123-2507
Phone
(504) 738-1567
NPI assigned
May 28, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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 7564 LA Primary

Addresses

Primary practice location

9541 Jefferson Hwy
River Ridge, LA 70123-2507

Mailing address

6512 Boutall St
Metairie, LA 70003-3551
Phone (504) 275-6422

Other practice location 1

1501 32nd St
Kenner, LA 70065-3204
Phone (504) 275-6422

Other practice location 2

40470 Germany Rd
Gonzales, LA 70737-6735
Phone (225) 622-2022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20240718000962 LA Order and Referring Only - DentistPractitioner - Dentist 6901342625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7564LAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kellene M. Cole DDS a.P.D.C. CurrentSince Jun 2, 2024 Accepting new patients
Ascension Dental Associates, LLC General Practice PastSince Sep 28, 2025 Accepting new patients

Locations

9541 Jefferson Hwy
River Ridge, LA 70123
Phone (504) 738-1567

Organizations & group practices 2

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": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1750121810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6512 BOUTALL ST",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700033551",
            "telephone_number": "504-275-6422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9541 JEFFERSON HWY",
            "city": "RIVER RIDGE",
            "state": "LA",
            "postal_code": "701232507",
            "telephone_number": "504-738-1567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 32nd St",
            "address_purpose": "LOCATION",
            "city": "Kenner",
            "state": "LA",
            "postal_code": "700653204",
            "country_code": "US",
            "telephone_number": "504-275-6422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "40470 Germany Rd",
            "address_purpose": "LOCATION",
            "city": "Gonzales",
            "state": "LA",
            "postal_code": "707376735",
            "country_code": "US",
            "telephone_number": "225-622-2022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JORGE",
        "middle_name": "ALEJANDRO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in River Ridge, LA

Sources for this page

Verify at the official NPI Registry.