Individual provider Active NPI

Mailyn Rodriguez

  • General Practice Dentistry
  • Ocoee, FL
National Provider Identifier
1902598733
Registry record updated Jul 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN30584 Issued in FL
Practice address
1231 Blackwood Ave
Ocoee, FL 34761-4521
Phone
(407) 477-5004
NPI assigned
May 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN30584 FL Primary

Addresses

Primary practice location

1231 Blackwood Ave
Ocoee, FL 34761-4521

Mailing address

460 S Kirkman Rd Apt 1020
Orlando, FL 32811-2037
Phone (786) 333-8572

Other practice location 1

2490 Enterprise Rd
Orange City, FL 32763-7902
Phone (386) 951-1412

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
DN30584FLMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751760000000",
    "number": "1902598733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 S KIRKMAN RD APT 1020",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328112037",
            "telephone_number": "786-333-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 BLACKWOOD AVE",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614521",
            "telephone_number": "407-477-5004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2490 Enterprise Rd",
            "address_purpose": "LOCATION",
            "city": "Orange City",
            "state": "FL",
            "postal_code": "327637902",
            "country_code": "US",
            "telephone_number": "386-951-1412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MAILYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2025-07-06",
        "certification_date": "2025-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN30584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.