Individual provider Active NPI

Ricky Joe Rodgers, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • West Point, NY
National Provider Identifier
1871698456
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
12619 Issued in TX
Practice address
US Army Dental Activity
Dentac, BLDG 606, 1St Floor
West Point, NY 10996-1905
Phone
(845) 938-2449
Fax
(845) 938-4302
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 12619 TX Primary

Addresses

Primary practice location

US Army Dental Activity
Dentac, BLDG 606, 1St Floor
West Point, NY 10996-1905

Mailing address

United States Military Academy
Dentac, 646 Swift Rd
West Point, NY 10996-1905
Phone (845) 938-2449

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
12619TXMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871698456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNITED STATES MILITARY ACADEMY",
            "address_2": "DENTAC, 646 SWIFT RD",
            "city": "WEST POINT",
            "state": "NY",
            "postal_code": "109961905",
            "telephone_number": "845-938-2449",
            "fax_number": "845-938-4302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US ARMY DENTAL ACTIVITY",
            "address_2": "DENTAC, BLDG 606, 1ST FLOOR",
            "city": "WEST POINT",
            "state": "NY",
            "postal_code": "109961905",
            "telephone_number": "845-938-2449",
            "fax_number": "845-938-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "RICKY",
        "middle_name": "JOE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "12619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Point, NY

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.