Kenneth Rodriguez, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1749 Issued in NM

Practice address

3740 Coors Blvd NW Ste a
Albuquerque, NM 87120-4762

Phone

(505) 836-1280

Fax

(505) 839-4782

NPI assigned

Jul 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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 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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Canoncito Band of Navajos Health Center, Inc.

  • Rural Health Clinic/Center
  • To'hajiilee, NM
  • NPI 1578010070

  TX

  Medicare reassignment NPD
• North Coors Dental

  • Dentist
  • Albuquerque, NM
  • NPI 1215952189
  NPD (past) Authorized official
• Canoncito Band of Navajos Health Center, Inc

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Canoncito, NM
  • NPI 1629525605
  NPD

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962421610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 COORS BLVD NW STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871204762",
            "telephone_number": "505-836-1280",
            "fax_number": "505-839-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 COORS BLVD NW STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871204762",
            "telephone_number": "505-836-1280",
            "fax_number": "505-839-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "KENNETH",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "1749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Louis Rodriguez, PT, DPT
• Julia Rodriguez, LISW LICENSED INDEPE
• Julie K Rodriguez, RN, BSN, OCN
• Julio Rodriguez
• Kelly M Rodriguez
• Larimar Ivette Rodriguez, MD
• Laura Rodriguez
• Laura C Rodriguez, LCSW
• Lisa Marie Rodriguez, M.S., CCC-SLP
• Margaret T Rodriguez, PA-C

• Dentist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Dentist in New Mexico

• 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.
• 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.