Elianys Yoseli Mavares Rodriguez, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14504 Issued in NC

Practice address

1890 N Broad St Ste 100
Fuquay Varina, NC 27526-3657

Phone

(919) 295-2757

NPI assigned

Feb 24, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

State licenses

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1912703653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 N BROAD ST STE 100",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275263657",
            "telephone_number": "919-586-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 N BROAD ST STE 100",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275263657",
            "telephone_number": "919-295-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVARES RODRIGUEZ",
        "first_name": "ELIANYS",
        "middle_name": "YOSELI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "14504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Logan Martin
• Keisha Mineth Martinez Cartagena, PHARMD
• Julia Martinez
• Kara Mason, LCMHC
• Jennifer Hyra Matthieu, LCSW
• Andrew Richard May, O.D.
• Sydney Mayle, PHARM D
• Lauren McBean, M.S., CF-SLP
• Tarsha Medley McBride, RN
• Kyanna Nikohl McCafferty, LCSWA

• General Practice Dentistry in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; 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.