NPIMap

Organization Active NPI

Rudy Carballo DDS PA

  • General Practice Dentistry
  • North Port, FL
National Provider Identifier
1801765813
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
RUDY CARBALLO DDS PA
Practice address
4901 White Ibis Dr
North Port, FL 34287-2641
Phone
(941) 257-8555
NPI assigned
Oct 30, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Authorized official

Name
Dr. Rodolfo Carballo, DDSNPI 1235466269
Title
Dentist/Owner
Phone
(941) 257-8555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4901 White Ibis Dr
North Port, FL 34287-2641

Mailing address

4901 White Ibis Dr
North Port, FL 34287-2641
Phone (941) 257-8555

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1761782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761782400000",
    "number": "1801765813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 WHITE IBIS DR",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342872641",
            "telephone_number": "941-257-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 WHITE IBIS DR",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342872641",
            "telephone_number": "941-257-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUDY CARBALLO DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-30",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A",
        "authorized_official_last_name": "CARBALLO",
        "authorized_official_first_name": "RODOLFO",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "941-257-8555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Port, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.