Active NPI
Ricky Joe Rodgers, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- West Point, NY
National Provider Identifier
1871698456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 12619
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 12619 | TX | MD | Orthodontics 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.