Individual provider Active NPI

Ruth Rodriguez, D.D.S.

  • General Practice Dentistry
  • San Juan, PR
National Provider Identifier
1760407795
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2325 Issued in PR
Practice address
654 Ave Munoz Rivera
Suite 1104
San Juan, PR 00918-4123
Phone
(787) 764-1414
Fax
(787) 763-3885
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2325 PR Primary
General Practice Dentistry 1223G0001X IL

Addresses

Primary practice location

654 Ave Munoz Rivera
Suite 1104
San Juan, PR 00918-4123

Mailing address

654 Ave Munoz Rivera
Suite 1104
San Juan, PR 00918-4123
Phone (787) 764-1414

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
019021146ILMDGeneral Practice Dentistry
2325PRMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760407795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 AVE MUNOZ RIVERA",
            "address_2": "SUITE 1104",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009184123",
            "telephone_number": "787-764-1414",
            "fax_number": "787-763-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 AVE MUNOZ RIVERA",
            "address_2": "SUITE 1104",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009184123",
            "telephone_number": "787-764-1414",
            "fax_number": "787-763-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2325",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.