Active NPI
Jorge Alejandro Rodriguez, DDS
- General Practice Dentistry
- River Ridge, LA
National Provider Identifier
1750121810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7564
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240718000962 | LA | Order and Referring Only - Dentist | 6901342625 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7564 | LA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kellene M. Cole DDS a.P.D.C. | Current | Accepting new patients | |
| Ascension Dental Associates, LLC | General Practice | Past | 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.
-
- Dentist
- River Ridge, LA
- NPI 1710015474
-
- General Practice Dentistry
- Gonzales, LA
- NPI 1265753800
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.