# JOSE' R. RODRIGUEZ, D.D.S., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053356956
- **Authorized official:** JOSE' RAFAEL RODRIGUEZ D.D.S. (OWNER/PRESIDENT)
- **Authorized official phone:** (913) 631-5600

## Contact information

- **Practice address:** 12480 W 62ND TER, SUITE 200, SHAWNEE MISSION, KS 66216-1810
- **Practice address phone:** (913) 631-5600
- **Practice address fax:** (913) 631-2602
- **Mailing address:** 12480 W 62ND TER, SUITE 200, SHAWNEE MISSION, KS 66216-1810
- **Mailing address phone:** (913) 631-5600
- **Mailing address fax:** (913) 631-2602

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 60039 | KS | Yes |

## Other

- **Enumeration date:** 06/17/2006
- **Last updated:** 08/22/2020