Marvin Dale Rodrigue Jr., D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

18878 Issued in TX

Practice address

2729 Silverlake Pkwy Ste 101
Pearland, TX 77584-1852

Phone

(713) 436-4555

Fax

(281) 412-6784

NPI assigned

Aug 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1851309934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2729 SILVERLAKE PKWY STE 101",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775841852",
            "telephone_number": "713-436-4555",
            "fax_number": "281-412-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2729 SILVERLAKE PKWY STE 101",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775841852",
            "telephone_number": "713-436-4555",
            "fax_number": "281-412-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUE",
        "first_name": "MARVIN",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "18878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147089001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "969593",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirbrina Robinson
• Shana Robinson
• Destiny Robledo
• Amanda R Roddy, MCD, CCC-SLP
• Adrian Joy Rodrigue, BCBA
• Luis Rodriguez Gonzalez, SA-C
• Amiramia Rodriguez, LCSW
• Arick Angel Rodriguez, OPA-C, SA-C
• Audelia Rodriguez
• Brittany Rodriguez

• Dentist in Pearland, TX
• Providers in Pearland, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.

Verify at the official NPI Registry.