Iveliss Rodriguez, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN23099 Issued in FL

Practice address

12801 W Sunrise Blvd # F222
Sunrise, FL 33323-4020

Phone

(954) 846-7171

NPI assigned

Nov 15, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Altamonte Mall Dental PA

  • Dentist
  • Altamonte Springs, FL
  • NPI 1063768372
  NPD (past)
• Sawgrass Mills Mall Dental, PA

  • General Practice Dentistry
  • Sunrise, FL
  • NPI 1306088133
  NPD (past)

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1962971200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 SABAL PALM DR APT 405",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333245938",
            "telephone_number": "786-357-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12801 W SUNRISE BLVD # F222",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333234020",
            "telephone_number": "954-846-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "IVELISS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN23099",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN23099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn Rodriguez-Broussard
• Alba Stefany Rodriguez, BEHAVIOR ASSISTANT
• Diva Rodriguez
• Edwin Rodriguez, M.D.
• Isabella Del Carmen Rodriguez, PHARMD
• Josie J Rodriguez, SLP-A
• Maria Cristina Rodriguez, LMT
• Nohora I Rodriguez, DMD
• Sergio Rodriguez
• Soly Rodriguez

• Periodontics in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.