Individual
DR. JOHN G RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2939 REGENCY DR, EDINBURG, TX 78539-2216
(956) 630-4900
(956) 682-9806
Mailing address
2939 REGENCY DR, EDINBURG, TX 78539-2216
(956) 630-4900
(956) 682-9806
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14566
TX
1223G0001X
General Practice Dentistry
14566
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120777102
—
TX
01
—
693641
UNITED CONCORDIA PROVIDER
TX
01
—
B14566
CHIP PROVIDER ID
TX
01
—
D14566
BC/BS PROVIDER (TEXAS)
TX
Enumeration date
10/31/2006
Last updated
04/26/2024
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