Individual provider Active NPI

Roderick Henry Adams Jr., DDS

  • General Practice Dentistry
  • University Heights, OH
National Provider Identifier
1982770715
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.015634 Issued in OH
Practice address
13922 Cedar Rd # 3
University Heights, OH 44118-3204
Phone
(216) 721-0500
Fax
(216) 721-5775
NPI assigned
Nov 24, 2006
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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 30.015634 OH Primary

Addresses

Primary practice location

13922 Cedar Rd # 3
University Heights, OH 44118-3204

Mailing address

13922 Cedar Rd # 3
University Heights, OH 44118-3204
Phone (216) 721-0500

Other identifiers 1

IdentifierTypeStateIssuer
0558383MedicaidOH

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
30.015634OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Marino and Associates Inc General Practice CurrentSince Jul 28, 2024 Accepting new patients

Locations

13922 Cedar Rd
#3
University Heights, OH 44118
Phone (216) 721-0500

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1982770715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13922 CEDAR RD # 3",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441183204",
            "telephone_number": "216-721-0500",
            "fax_number": "216-721-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13922 CEDAR RD # 3",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441183204",
            "telephone_number": "216-721-0500",
            "fax_number": "216-721-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "RODERICK",
        "middle_name": "HENRY",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.015634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0558383",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in University Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.